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劳伦斯·D·多尔外科技术与技术奖:“同时进行两台手术”并不影响关节置换术的结果或患者安全。

The Lawrence D. Dorr Surgical Techniques & Technologies Award: "Running Two Rooms" Does Not Compromise Outcomes or Patient Safety in Joint Arthroplasty.

机构信息

Anderson Orthopaedic Research Institute, Alexandria, VA.

出版信息

J Arthroplasty. 2018 Jul;33(7S):S8-S12. doi: 10.1016/j.arth.2018.01.011. Epub 2018 Jan 31.

DOI:10.1016/j.arth.2018.01.011
PMID:29452974
Abstract

BACKGROUND

Scrutiny from the federal government and the media regarding the safety of 1 surgeon doing cases in 2 operating rooms (ORs) on the same day, prompted us to examine our own institutional data. Over the past 11 years, surgeons at our facility have operated consecutively in 1 OR on a given day or used 2 alternating ORs. This study compares these cases with a focus on revisions and complications in both groups.

METHODS

Six surgeons performed a total of 16,916 primary hip and knee arthroplasties from 2006-2016. 7002 cases (41%) were consecutive cases (CCs) and 9914 cases (59%) were overlapping cases (OCs). Intraoperative complications, component revisions, and postoperative complications within 90 days of surgery were compared between the CC and OC groups.

RESULTS

There was no difference in intraoperative complication rates between the two groups (CC 1.6% vs. OC 1.7%, relative risk 1.082, 95% confidence interval 0.852 to 1.375, P = .52). There was no difference in 90-day component revision rates among the CC and OC groups (0.66% vs. 0.85% respectively, relative risk = 1.290, 95% confidence interval 0.901 to 1.845, P = .19). There was also no difference in 90-day complication rates among the CC and OC groups (1.33% vs. 1.45% respectively, relative risk = 1.094, 95% confidence interval 0.844 to 1.417, P = .54).

CONCLUSION

This large study of a single institution with multiple surgeons over an 11-year period shows no compromise in patient safety or outcomes when comparing cases done in either consecutive or overlapping rooms.

摘要

背景

联邦政府和媒体对一名外科医生在同一天于 2 个手术室(OR)中进行手术的安全性进行了审查,这促使我们检查我们自己的机构数据。在过去的 11 年中,我们医院的外科医生在给定的一天连续在 1 个 OR 中进行手术,或者使用 2 个交替的 OR。本研究比较了这两组病例,重点是两组的翻修和并发症。

方法

六名外科医生在 2006 年至 2016 年间共进行了 16916 例髋关节和膝关节初次置换术。7002 例(41%)为连续病例(CC),9914 例(59%)为重叠病例(OC)。比较 CC 和 OC 组之间手术中的并发症、组件翻修和术后 90 天内的并发症。

结果

两组之间手术中的并发症发生率无差异(CC 为 1.6%,OC 为 1.7%,相对风险 1.082,95%置信区间 0.852 至 1.375,P =.52)。CC 和 OC 组之间 90 天组件翻修率也无差异(分别为 0.66%和 0.85%,相对风险= 1.290,95%置信区间 0.901 至 1.845,P =.19)。CC 和 OC 组之间 90 天并发症发生率也无差异(分别为 1.33%和 1.45%,相对风险= 1.094,95%置信区间 0.844 至 1.417,P =.54)。

结论

这项针对一家机构多位外科医生进行的长达 11 年的大型研究表明,在比较连续或重叠房间进行的病例时,患者的安全性或结果没有受到影响。

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