Delay in anesthesia assessment time – A cause of postponement in orthopedic trauma surgery

Abstract

Background: Postponement of surgery increases the length of hospitalization and medical expenses, the mortality rate, and the prevalence of major medical complications. There is a limited study about the role of anesthesia assessment in developing these complications. Thus, the aim of the present study was to examine the anesthesia assessment time for traumatic patients aged over 50 years and also to investigate the role of anesthesia service in surgery postponement. Materials and Methods: This descriptive retrospective study was performed on 110 patients with traumatic injuries referred to Imam Khomeini Hospital Complex (Tehran, Iran) from March to September 2017. The information was extracted retrospectively from the hospital information system. The standard definitions in the International Classification of Diseases 10 code S00-T88 were used to identify traumatic injuries and fractures. Results: The results of the present study showed that the mean of anesthesia assessment time was significantly different in terms of the type of trauma, and femoral fractures had a higher anesthesia assessment time (P = 0.009). Furthermore, the anesthesia assessment time in patients who underwent echocardiography was significantly higher than those with no echocardiography (P < 0.05). The current study explored that the mean anesthesia assessment time was substantially higher in patients who underwent myocardial perfusion imaging (MPI) (7.1 vs. 1.84 days). Furthermore, the results revealed that there was no significant difference in anesthesia assessment time regarding gender of the patients (3 vs. 2.7 days). Finally, patients aged between 61 and 70 years had a higher anesthesia assessment time with a mean of 4.41 days (P < 0.05). Conclusions: The study concluded that the mean of anesthesia assessment time was significantly higher (3.6 days) in patients with a femoral fracture. Furthermore, this study has shown that diagnostic assessments, including echocardiography, MPI, and angiography, which were performed in some patients, did not change the surgery plan.