Emergency general surgery
Acute care pathways, variation in management, comparative effectiveness, risk-adjusted outcomes, and system performance in emergency general surgery.
Research
Research designed for the realities of trauma, emergency surgery, and critical care.
CESOR focuses on clinically consequential questions in high-acuity surgical care, with emphasis on practice variation, comparative effectiveness, implementation, and outcomes that matter to patients, clinicians, and health systems.
Research strategy
A clinically grounded, methodologically rigorous portfolio.
CESOR develops multicenter observational studies, prospective snapshot cohort studies, and analytically robust evaluations built around real-world emergency surgical practice. Across programs, the emphasis is consistent: important clinical questions, standardized data capture, careful outcome definition, and study designs capable of informing practice rather than simply describing it.
The center places particular emphasis on identifying unwarranted variation in care, evaluating the effectiveness of commonly used interventions, and generating evidence that can support more consistent, evidence-informed decision-making across institutions and health systems.
Methodologically, CESOR draws on advanced observational and causal inference approaches where appropriate, while remaining anchored in clinical feasibility and relevance. Research is conducted within collaborative networks that allow consecutive, real-world patient data to be studied across diverse settings.
The result is a portfolio intended not only to generate publishable findings, but to create a durable evidence base for improvement in trauma, emergency surgery, and surgical critical care.
Priority domains
Core areas of inquiry.
Trauma outcomes
Trauma care processes, physiologic risk, failure-to-rescue, recovery trajectories, and sources of outcome variation in injured patients.
Critical care and perioperative science
Postoperative deterioration, ICU-linked outcomes, airway and resuscitation practices, resource use, and decision-making in high-acuity perioperative environments.
Active studies
Programs built around high-consequence clinical questions.
Appendicitis
SnapAppy
SnapAppy is an international prospective snapshot cohort study of acute appendicitis designed to characterize contemporary patterns of presentation, operative and non-operative management, antibiotic use, and short-term outcomes. Using standardized prospective capture with 90-day follow-up, the study examines how variation in guideline adherence, technical choices, and care pathways relates to complications, readmissions, and recovery.
Bowel obstruction
SnapSBO
SnapSBO is a multicenter, time-bound prospective observational study of small-bowel obstruction capturing consecutive patients during a defined enrollment window across international centers. It characterizes diagnostic pathways, imaging use, non-operative management, operative timing, and downstream outcomes in order to benchmark current practice and identify priorities for future comparative and implementation-focused work.
Surgical infection
Snap NSTI
Snap NSTI is an international prospective cohort study focused on necrotizing soft tissue infection, one of the highest-acuity emergencies in surgery. The protocol captures case mix, diagnostic pathways, timing and extent of debridement, antimicrobial and adjunctive therapies, and 90-day outcomes in a standardized fashion, with the goal of clarifying practice variation and informing future guidelines and interventional trial design.
Colorectal emergency surgery
IMPEL
IMPEL studies mechanical large-bowel obstruction through a prospective international snapshot audit of consecutive adult patients presenting with this high-risk emergency. It is designed to describe contemporary diagnostic and therapeutic strategies and to link those strategies to short-term morbidity, mortality, critical care use, and stoma-related outcomes.
Airway safety
PHAROAH
PHAROAH is an international multicenter prospective snapshot audit of adult inpatient tracheal intubations in patients with a physiologically hazardous airway. By linking airway strategy and preparation to early peri-intubation outcomes, the study is designed to identify modifiable care processes and inform future implementation, quality-improvement, and interventional work across acute care settings.
Systems and readiness
EGS-READI
EGS-READI is a cross-sectional environmental scan examining how ready emergency general surgery services are to adopt enabling technologies such as fluorescence imaging, emergency robotics, AI-assisted decision support, and digitally supported perioperative pathways. The study evaluates structural determinants of implementation and is intended to provide an empirical basis for strategic investment and future multicenter implementation studies.
Implementation science
PONG
PONG addresses the common but poorly standardized problem of postoperative nasogastric tube management. Beginning with practice-pattern surveys and a prospective snapshot audit structured to emulate a target trial, the program studies how bedside decision-making relates to reinsertion, length of stay, and recovery outcomes, with the longer-term goal of supporting decision tools and future effectiveness-implementation work.