Chan Grace, Butterworth Sonia A
Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Division of Pediatric Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada; Division of Pediatric Surgery, Department of Surgery, British Columbia Children's Hospital, Vancouver, BC, Canada.
J Pediatr Surg. 2016 May;51(5):838-42. doi: 10.1016/j.jpedsurg.2016.02.033. Epub 2016 Feb 16.
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.
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, 2A, 2B, and 3: target times of 1, 6, 24 and 72h. In hours (IH)=7:45AM-3:30PM, M-F; others were out of hours (OOH) and overnight =2300-0700.
There were 4668 operations: class 1 (5.8%), 2A (29.1%), 2B (42.1%), and 3(23%). For class 1, 2A, 2B, and 3 surgeries, mean in-room times were 2, 4.7, 15.4, and 54h respectively; 59.2% (class 1), 81.9% (class 2A), 81.2% (class 2B) and 74.4%(class 3) were performed in target. OOH occurred for 73.2% (class 1), 71.5%(class 2A), 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%.
The majority of urgent/emergent surgery occurred OOH and the most unstable patients are least likely to have their operation within target.
关于加拿大紧急/急诊手术等待时间的文献较少。非急诊手术在夜间的延迟和执行情况会增加发病率和死亡率。本研究的目的是确定夜间不太紧急手术的延迟模式和执行情况。
使用ORSOS数据库（前瞻性患者和手术数据）对2011年6月至2013年12月期间的急诊/紧急手术进行回顾性分析。手术分为：1类、2A类、2B类和3类：目标时间分别为1小时、6小时、24小时和72小时。工作时间（IH）=周一至周五上午7:45至下午3:30；其他时间为非工作时间（OOH），夜间为23:00至07:00。
共有4668例手术：1类（5.8%）、2A类（29.1%）、2B类（42.1%）和3类（23%）。对于1类、2A类、2B类和3类手术，平均住院时间分别为2小时、4.7小时、15.4小时和54小时；59.2%（1类）、81.9%（2A类）、81.2%（2B类）和74.4%（3类）在目标时间内完成。1类手术的非工作时间发生率为73.2%，2A类为71.5%，2B类为54.7%，3类为27.7%。夜间有37例2B类和3类手术。工作时间内的手术有显著增加：从41.8%增至49.6%。
大多数紧急/急诊手术在非工作时间进行，最不稳定的患者最不可能在目标时间内进行手术。
4级。
