Wilson David J, Crawford David A, Arrington Edward D
Madigan Army Medical Center, Building 9040, Fitzsimmons Drive, Tacoma, WA 98431, USA.
Mil Med. 2012 Jun;177(6):740-4. doi: 10.7205/milmed-d-11-00431.
We performed a retrospective review of elective orthopedic surgeries performed at our institution in 2008. Surgical wait time was defined as the interval between when surgery was offered and when it was performed. Data were available for 1,120 patients and included date and type of procedure, patient age, American Society of Anesthesia (ASA) category, and military rank. Mean wait time for all procedures was 69.1 days. Significant differences were found with regard to patient age, ASA class, rank, and type of procedure. Older patients with higher ASA had significantly longer wait times. Enlisted soldiers had the shortest wait times and retirees the longest. Total joint procedures had the longest wait time (mean 140 days) and the highest anesthesia class. Elective trauma procedures had the shortest wait time (mean 27.2 days). Sports procedures accounted for 46.3% of all cases reviewed. In our cohort, older patients with higher ASA class and those undergoing a total joint procedure can expect longer preoperative wait times. No preferential care given to officers, as enlisted soldiers had the shortest wait times. At our military medical center, which closely models a managed care system, patients can expect to wait more than 2 months for elective orthopedic surgeries.
我们对2008年在我院进行的择期骨科手术进行了回顾性研究。手术等待时间定义为从提供手术到实际进行手术之间的间隔。我们获取了1120例患者的数据,包括手术日期和类型、患者年龄、美国麻醉医师协会(ASA)分级以及军衔。所有手术的平均等待时间为69.1天。在患者年龄、ASA分级、军衔和手术类型方面发现了显著差异。年龄较大、ASA分级较高的患者等待时间明显更长。现役士兵等待时间最短,退休人员最长。全关节手术等待时间最长(平均140天),麻醉分级最高。择期创伤手术等待时间最短(平均27.2天)。运动手术占所有审查病例的46.3%。在我们的队列中,年龄较大、ASA分级较高的患者以及接受全关节手术的患者术前等待时间更长。未对军官给予特殊照顾,因为现役士兵等待时间最短。在我们这个紧密模拟管理式医疗系统的军事医疗中心,患者进行择期骨科手术预计要等待两个多月。