影响初次和翻修全膝关节置换术手术室排班准确性的因素:回顾性研究

IF 1.1 4区 医学 Q3 ORTHOPEDICS Orthopedics Pub Date : 2024-09-01 Epub Date: 2024-07-08 DOI:10.3928/01477447-20240702-01
Casey Cardillo, Conor Garry, Jonathan L Katzman, Morteza Meftah, Joshua C Rozell, Ran Schwarzkopf, Claudette Lajam
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引用次数: 0

摘要

背景:优化手术室(OR)调度的准确性对于提高手术室效率和最大化全膝关节置换术(TKA)的价值非常重要。然而,有关可能影响 TKA 手术室时间安排准确性的因素的数据却很有限:对 2020 年 1 月至 2023 年 5 月间进行的 7655 例膝关节置换术(6999 例初次 TKA 和 656 例翻修 TKA)进行了回顾性分析。收集了患者基线特征、外科医生经验(从业年限)以及实际手术时间与计划手术时间。实际手术时间比计划手术时间至少缩短或延长 15%,则被认为具有临床意义。采用逻辑回归分析评估特定患者和外科医生因素对手术排期不准确性的影响:结果:使用调整后的几率比,体重指数(PPPP=.037)较低的初级TKA患者、体重指数(PP=.021)较高的患者和早上手术开始时间(P=.038)与高估计划手术时间有关,而经验少于10年的外科医生(P=.014)和接受脊髓/硬膜外/阻滞麻醉的患者(P=.038)与低估计划手术时间有关:本研究强调了影响 TKA 手术时间安排准确性的患者、外科医生和术中变量。医疗系统在制定手术室时间表时应将这些变量考虑在内,以充分优化资源和可用空间。[骨科。202x;4x(x):xx-xx]。
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Factors Affecting Operating Room Scheduling Accuracy for Primary and Revision Total Knee Arthroplasty: A Retrospective Study.

Background: Optimizing operating room (OR) scheduling accuracy is important for improving OR efficiency and maximizing value of total knee arthroplasty (TKA). However, data on factors that may impact TKA OR scheduling accuracy are limited.

Materials and methods: A retrospective review of 7655 knee arthroplasties (6999 primary TKAs and 656 revision TKAs) performed between January 2020 and May 2023 was conducted. Patient baseline characteristics, surgeon experience (years in practice), as well as actual vs scheduled OR times were collected. Actual OR times that were at least 15% shorter or longer than scheduled OR times were considered to be clinically important. Logistic regression analyses were employed to assess the influence of specific patient and surgeon factors on OR scheduling inaccuracies.

Results: Using adjusted odds ratio, patients with primary TKA who had a lower body mass index (P<.001) were independently associated with overestimation of scheduled surgical time. Conversely, younger age (P<.001), afternoon procedure start time (P<.001), surgeons with less than 10 years of experience (P=.037), and higher patient body mass index (P<.001) were associated with underestimation of scheduled surgical time. For revision TKA, female sex (P=.021) and morning procedure start time (P=.038) were associated with overestimation of scheduled surgical time, while surgeons with less than 10 years of experience (P=.014) and patients who underwent spinal/epidural/block anesthesia (P=.038) were associated with underestimation of scheduled surgical time.

Conclusion: This study highlights patient, surgeon, and intraoperative variables that impact the accuracy of scheduling for TKA procedures. Health systems should take these variables into consideration when creating OR schedules to fully optimize resources and available space. [Orthopedics. 2024;47(5):313-319.].

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来源期刊
Orthopedics
Orthopedics 医学-整形外科
CiteScore
2.20
自引率
0.00%
发文量
160
审稿时长
3 months
期刊介绍: For over 40 years, Orthopedics, a bimonthly peer-reviewed journal, has been the preferred choice of orthopedic surgeons for clinically relevant information on all aspects of adult and pediatric orthopedic surgery and treatment. Edited by Robert D''Ambrosia, MD, Chairman of the Department of Orthopedics at the University of Colorado, Denver, and former President of the American Academy of Orthopaedic Surgeons, as well as an Editorial Board of over 100 international orthopedists, Orthopedics is the source to turn to for guidance in your practice. The journal offers access to current articles, as well as several years of archived content. Highlights also include Blue Ribbon articles published full text in print and online, as well as Tips & Techniques posted with every issue.
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