外科医生受手术室周转延迟影响对患者预后的影响。

IF 3.5 3区 医学 Q1 SURGERY BJS Open Pub Date : 2024-09-03 DOI:10.1093/bjsopen/zrae117
Arnaud Pasquer, Quentin Cordier, Jean-Christophe Lifante, Gilles Poncet, Stéphanie Polazzi, Antoine Duclos
{"title":"外科医生受手术室周转延迟影响对患者预后的影响。","authors":"Arnaud Pasquer, Quentin Cordier, Jean-Christophe Lifante, Gilles Poncet, Stéphanie Polazzi, Antoine Duclos","doi":"10.1093/bjsopen/zrae117","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>A surgeon's daily performance may be affected by operating room organizational factors, potentially impacting patient outcomes. The aim of this study was to investigate the link between a surgeon's exposure to delays in starting scheduled operations and patient outcomes.</p><p><strong>Methods: </strong>A prospective observational study was conducted from 1 November 2020 to 31 December 2021, across 14 surgical departments in four university hospitals, covering various surgical disciplines. All elective surgeries by 45 attending surgeons were analysed, assessing delays in starting operations and inter-procedural wait times exceeding 1 or 2 h. The primary outcome was major adverse events within 30 days post-surgery. Mixed-effect logistic regression accounted for operation clustering within surgeons, estimating adjusted relative risks and outcome rate differences using marginal standardization.</p><p><strong>Results: </strong>Among 8844 elective operations, 4.0% started more than 1 h late, associated with an increased rate of adverse events (21.6% versus 14.4%, P = 0.039). Waiting time surpassing 1 h between procedures occurred in 71.4% of operations and was also associated with a higher frequency of adverse events (13.9% versus 5.3%, P < 0.001). After adjustment, delayed operations were associated with an elevated risk of major adverse events (adjusted relative risk 1.37 (95% c.i. 1.06 to 1.85)). The standardized rate of major adverse events was 12.1%, compared with 8.9% (absolute difference of 3.3% (95% c.i. 0.6% to 5.6%)), when a surgeon experienced a delay in operating room scheduling or waiting time between two procedures exceeding 1 h, as opposed to not experiencing such delays.</p><p><strong>Conclusion: </strong>A surgeon's exposure to delay before starting elective procedures was associated with an increased occurrence of major adverse events. Optimizing operating room turnover to prevent delayed operations and waiting time is critical for patient safety.</p>","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":null,"pages":null},"PeriodicalIF":3.5000,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11477981/pdf/","citationCount":"0","resultStr":"{\"title\":\"Influence of a surgeon's exposure to operating room turnover delays on patient outcomes.\",\"authors\":\"Arnaud Pasquer, Quentin Cordier, Jean-Christophe Lifante, Gilles Poncet, Stéphanie Polazzi, Antoine Duclos\",\"doi\":\"10.1093/bjsopen/zrae117\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>A surgeon's daily performance may be affected by operating room organizational factors, potentially impacting patient outcomes. The aim of this study was to investigate the link between a surgeon's exposure to delays in starting scheduled operations and patient outcomes.</p><p><strong>Methods: </strong>A prospective observational study was conducted from 1 November 2020 to 31 December 2021, across 14 surgical departments in four university hospitals, covering various surgical disciplines. All elective surgeries by 45 attending surgeons were analysed, assessing delays in starting operations and inter-procedural wait times exceeding 1 or 2 h. The primary outcome was major adverse events within 30 days post-surgery. Mixed-effect logistic regression accounted for operation clustering within surgeons, estimating adjusted relative risks and outcome rate differences using marginal standardization.</p><p><strong>Results: </strong>Among 8844 elective operations, 4.0% started more than 1 h late, associated with an increased rate of adverse events (21.6% versus 14.4%, P = 0.039). Waiting time surpassing 1 h between procedures occurred in 71.4% of operations and was also associated with a higher frequency of adverse events (13.9% versus 5.3%, P < 0.001). After adjustment, delayed operations were associated with an elevated risk of major adverse events (adjusted relative risk 1.37 (95% c.i. 1.06 to 1.85)). The standardized rate of major adverse events was 12.1%, compared with 8.9% (absolute difference of 3.3% (95% c.i. 0.6% to 5.6%)), when a surgeon experienced a delay in operating room scheduling or waiting time between two procedures exceeding 1 h, as opposed to not experiencing such delays.</p><p><strong>Conclusion: </strong>A surgeon's exposure to delay before starting elective procedures was associated with an increased occurrence of major adverse events. Optimizing operating room turnover to prevent delayed operations and waiting time is critical for patient safety.</p>\",\"PeriodicalId\":9028,\"journal\":{\"name\":\"BJS Open\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2024-09-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11477981/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BJS Open\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/bjsopen/zrae117\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BJS Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/bjsopen/zrae117","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0

摘要

背景:外科医生的日常表现可能会受到手术室组织因素的影响,从而对患者预后产生潜在影响。本研究的目的是调查外科医生在开始预定手术时受到的延误与患者预后之间的联系:从 2020 年 11 月 1 日至 2021 年 12 月 31 日,在四家大学医院的 14 个外科部门开展了一项前瞻性观察研究,涵盖了不同的外科学科。对45名主治医生的所有择期手术进行了分析,评估了手术开始时间的延迟以及手术间等待时间超过1或2小时的情况。混合效应逻辑回归考虑了外科医生内部的手术分组情况,利用边际标准化估算了调整后的相对风险和结果率差异:在 8844 例择期手术中,4.0% 的手术开始时间晚于 1 小时,这与不良事件发生率增加有关(21.6% 对 14.4%,P = 0.039)。在71.4%的手术中,两次手术之间的等待时间超过了1小时,这也与不良事件发生率较高有关(13.9%对5.3%,P<0.001)。经调整后,延迟手术与重大不良事件风险升高有关(调整后相对风险为1.37(95% c.i.为1.06至1.85))。当外科医生在手术室排期或两台手术之间的等待时间超过1小时时,重大不良事件的标准化发生率为12.1%,而未经历此类延迟的发生率为8.9%(绝对差异为3.3%(95% c.i.0.6%至5.6%)):结论:外科医生在开始择期手术前遭遇延迟与重大不良事件的发生率增加有关。优化手术室周转以防止手术延迟和等待时间对患者安全至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Influence of a surgeon's exposure to operating room turnover delays on patient outcomes.

Background: A surgeon's daily performance may be affected by operating room organizational factors, potentially impacting patient outcomes. The aim of this study was to investigate the link between a surgeon's exposure to delays in starting scheduled operations and patient outcomes.

Methods: A prospective observational study was conducted from 1 November 2020 to 31 December 2021, across 14 surgical departments in four university hospitals, covering various surgical disciplines. All elective surgeries by 45 attending surgeons were analysed, assessing delays in starting operations and inter-procedural wait times exceeding 1 or 2 h. The primary outcome was major adverse events within 30 days post-surgery. Mixed-effect logistic regression accounted for operation clustering within surgeons, estimating adjusted relative risks and outcome rate differences using marginal standardization.

Results: Among 8844 elective operations, 4.0% started more than 1 h late, associated with an increased rate of adverse events (21.6% versus 14.4%, P = 0.039). Waiting time surpassing 1 h between procedures occurred in 71.4% of operations and was also associated with a higher frequency of adverse events (13.9% versus 5.3%, P < 0.001). After adjustment, delayed operations were associated with an elevated risk of major adverse events (adjusted relative risk 1.37 (95% c.i. 1.06 to 1.85)). The standardized rate of major adverse events was 12.1%, compared with 8.9% (absolute difference of 3.3% (95% c.i. 0.6% to 5.6%)), when a surgeon experienced a delay in operating room scheduling or waiting time between two procedures exceeding 1 h, as opposed to not experiencing such delays.

Conclusion: A surgeon's exposure to delay before starting elective procedures was associated with an increased occurrence of major adverse events. Optimizing operating room turnover to prevent delayed operations and waiting time is critical for patient safety.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
BJS Open
BJS Open SURGERY-
CiteScore
6.00
自引率
3.20%
发文量
144
期刊最新文献
Classifying histopathological growth patterns for resected colorectal liver metastasis with a deep learning analysis. Short-term outcomes depending on type of oesophagojejunostomy in laparoscopic total gastrectomy for gastric cancer: retrospective study based on a Korean Nationwide Survey for Gastric Cancer in 2019. Association of postoperative opioid type with mortality and readmission rates: multicentre retrospective cohort study. Effects of the superior mesenteric artery approach versus the no-touch approach during pancreatoduodenectomy on the mobilization of circulating tumour cells and clusters in pancreatic cancer (CETUPANC): randomized clinical trial. Reported outcomes in studies of intermittent claudication - first step toward a core outcome set: systematic review.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1