Audit of emergent and urgent surgery for acutely ill pediatric patients: is access timely?

作者：Chan Grace; Butterworth Sonia A^*

来源：Journal of Pediatric Surgery, 2016, 51(5): 838-842.

DOI：10.1016/j.jpedsurg.2016.02.033

• Emergency surgery
• Out of hours
• Surgical access

There is a paucity of literature about wait times for urgent/emergent surgeries in Canada. Delays and performance of non-emergent operations overnight increase morbidity and mortality. The study aim was to determine patterns of delays and performance of less-emergent surgery overnight.
Methods: A retrospective analysis (June 2011-December 2013) of emergent/urgent surgeries was conducted using the ORSOS database (prospective patient and operative data). Surgeries were classified: class 1, 2 A, 2B, and 3: target times of 1, 6, 24 and 72 h. In hours (IH) = 7:45 AM-3:30 PM, M-F; others were out of hours (OOH) and overnight = 2300-0700.
Results: There were 4668 operations: class 1 (5.8%), 2 A (29.1%), 2B (42.1%), and 3(23%). For class 1, 2 A, 2B, and 3 surgeries, mean in-room times were 2, 4.7, 15.4, and 54 h respectively; 59.2% (class 1), 81.9% (class 2 A), 81.2% (class 2B) and 74.4%(class 3) were performed in target. OOH occurred for 73.2% (class 1), 71.5%(class 2 A), 54.7% (class 2B), and 27.7% (class 3). There were 37 class 2B and 3 surgeries overnight. There was a significant increase surgeries IH: 41.8% to 49.6%.
Conclusion: Themajority of urgent/emergent surgery occurred OOH and the most unstable patients are least likely to have their operation within target.

• 出版日期2016-5