EGS Verification Linked to Lower Mortality and Shorter Stays

Patients at hospitals that earned ACS Emergency General Surgery (EGS) Verification showed improvements in mortality, acute kidney injury, and postoperative length of stay, according to a new study published in JAMA Surgery—among the first peer-reviewed, real-world data to demonstrate the effectiveness of the program.

Researchers analyzed ACS National Surgical Quality Improvement Program data for 21,858 patients who underwent emergency general surgery at 55 hospitals between July 2023 and December 2024. Using a difference-in-differences analysis, they compared changes at five hospitals that became verified with changes at 50 hospitals that did not undergo verification.

Relative to changes at unverified hospitals, verification was associated with:

• 28.8% lower 30-day postoperative mortality
• 29% lower acute kidney injury rates
• 1.31 fewer postoperative hospital days, a 19.7% reduction

The findings remained significant after risk adjustment and correction for multiple comparisons.

A separate before-and-after analysis of verified hospitals identified improvements in care delivery. Median time from admission to surgery decreased from 31.9 to 21.2 hours, while the proportion of patients admitted to an EGS service increased from 74.8% to 85.7%. Operations following unsuccessful nonoperative management decreased from 25.5% to 19%.

Clifford Y. Ko, MD, MS, MSHS, FACS, senior author and Senior Vice President of the ACS Division of Research and Optimal Patient Care, said the findings demonstrate that “the quality and timeliness of surgical care can be dramatically improved” through ACS verification.

First author Geoffrey Hobika, MD, an ACS Clinical Scholar in Residence and University of Buffalo surgery resident, emphasized that timeliness and quality are “important metrics also tied to reduced hospital costs.”

The results reflect early experience at five verified hospitals with limited follow-up. Participation was voluntary, and other differences among hospitals and patients may have influenced the findings. Further research will assess whether improvements persist as participation expands.

Developed with the American Association for the Surgery of Trauma, the Emergency General Surgery Verification Program (EGS-VP) establishes standards for hospital resources, care coordination, and quality improvement. For patients, this framework supports timely care and better outcomes; for hospitals, it offers opportunities to improve efficiency, optimize resources, and reduce costs associated with complications and prolonged stays.

Learn more about EGS-VP and how your hospital can participate.