Development of a Multidisciplinary Program to Expedite Care of Esophageal Emergencies DuyKhanh P. Ceppa, MD, Carlo Maria Rosati, MD, Lola Chabtini, MD,

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Development of a Multidisciplinary Program to Expedite Care of Esophageal Emergencies DuyKhanh P. Ceppa, MD, Carlo Maria Rosati, MD, Lola Chabtini, MD, Samantha M. Stokes, BS, Holly C. Cook, RN, Karen M. Rieger, MD, Thomas J. Birdas, MD, John C. Lappas, MD, William R. Kessler, MD, John M. DeWitt, MD, Dean D. Maglinte, MD, Kenneth A. Kesler, MD The Annals of Thoracic Surgery Volume 104, Issue 3, Pages 1054-1061 (September 2017) DOI: 10.1016/j.athoracsur.2017.03.023 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Triage algorithm for patient referral. Figure depicts the workflow of patients being referred to our institution for esophageal emergency. (IU = Indiana University; OD = operating department; OR = operating room; SICU = surgical intensive care unit.) The Annals of Thoracic Surgery 2017 104, 1054-1061DOI: (10.1016/j.athoracsur.2017.03.023) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Patient referral pattern and initial treatment delivered. Chart provides reasons for referral to our esophageal emergency program as well as initial treatment delivered. Eighty patients were referred for esophageal obstruction, suspected or documented perforation, and previous history of care at our institution. The Annals of Thoracic Surgery 2017 104, 1054-1061DOI: (10.1016/j.athoracsur.2017.03.023) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Volume of patients referred for esophageal emergencies before and after establishment of esophageal level 1 program. This graph depicts volume of patients referred to our institution for esophageal emergency in 6-month increments from April 2011 through November 2015. Arrow (April 2013) marks inception of esophageal level 1 program. Last data point consisted of referrals during 3-month period (September 2015–November 2015). The Annals of Thoracic Surgery 2017 104, 1054-1061DOI: (10.1016/j.athoracsur.2017.03.023) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions