Bypassing the Closest Surgical Site for Urgent Care Tied to Worse Outcomes

THURSDAY, Feb. 26, 2026 (HealthDay News) — For patients requiring urgent and emergent surgery, bypassing the nearest surgical hospital (NSH) is associated with worse clinical outcomes, according to a study published online Feb. 18 in the Journal of the American College of Surgeons.

Mustafa Abid, M.D., from the University of North Carolina at Chapel Hill, and colleagues conducted a multistate study to assess if bypassing locally available surgical care for urgent and emergent general surgical diseases is associated with worse outcomes. The analysis included 22,902 patients from Arizona, Iowa, North Carolina, Vermont, and Wisconsin who underwent urgent or emergent abdominal surgery in 2019. 

The researchers found that patients who bypassed their NSH did not have significantly increased odds of mortality (adjusted odds ratio [aOR], 1.25; 95 percent confidence interval, 0.87 to 1.80). However, bypass was associated with significantly increased odds of presenting with disease progression (aOR, 1.22). Bypass patients also had lower odds of transfer (aOR, 0.52), increased odds of complications (aOR, 1.12), and increased odds of prolonged length of stay (aOR, 1.20) when controlling for disease progression. These results persisted across stricter bypass definitions.

“It may be that early diagnosis, resuscitation, and medical intervention, including antibiotics, could improve patient outcomes, even if they required subsequent transfer for definitive surgical care,” the authors write. “However, evidence suggests that patients would often receive safe care locally as well.”

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