Broullón Dobarro Andrea, Cabadas Avión Rafael, Leal Ruiloba María Sonsoles, Vázquez Lima Ana, Ojea Cendón María, Fernández García Noelia, Nespereira García Paula, Climent Aira Antonio
Servicio de Anestesiología y Cuidados Intensivos, Hospital Povisa, Vigo, España.
Servicio de Anestesiología y Cuidados Intensivos, Hospital Povisa, Vigo, España.
Cir Esp (Engl Ed). 2019 Apr;97(4):213-221. doi: 10.1016/j.ciresp.2019.01.006. Epub 2019 Mar 7.
The main objective was the description and analysis of suspended surgeries and their causes for suspension at our hospital from the year 2010 to the present. As a secondary objective, we evaluated the effectiveness of a series of measures for improvement.
A retrospective study was conducted to analyze patients who were scheduled to undergo surgery that was finally suspended. A Failure Mode and Effects Analysis (FMEA) was carried out to analyze the causes of the suspensions and their consequences, any existing barriers and possible measures that have been implemented over time. The causes were classified as attributable to the patient, administrative causes and medical causes.
105,403 surgeries were scheduled, 3,867 of which were suspended (3.66%). Factors that influenced the suspensions included: surgical specialty, ASA 4 patients, elderly patients, ambulatory patients and surgeries scheduled during the winter. The most frequent medical cause was infection or fever (17.6%), while the most frequent administrative and patient causes were lack of time (26.8%) and no-show (6.3%), respectively. The avoidable causes were 64.8% versus 35.2% unavoidable causes. In the multivariate analysis, risk factors included age, shift, season and surgical service.
Surgical cancellations have repercussions on the consumption of material and human resources. Any means to reduce their incidence should be our future priority in order improve the quality of care.
主要目的是描述和分析我院2010年至今的手术暂停情况及其原因。作为次要目的，我们评估了一系列改进措施的有效性。
进行一项回顾性研究，分析那些已安排手术但最终被暂停的患者。开展失效模式与效应分析（FMEA），以分析手术暂停的原因及其后果、任何现有的障碍以及随着时间推移已实施的可能措施。原因分为患者因素、管理原因和医疗原因。
共安排了105,403例手术，其中3,867例被暂停（3.66%）。影响手术暂停的因素包括：手术专科、美国麻醉医师协会（ASA）分级为4级的患者、老年患者、门诊患者以及冬季安排的手术。最常见的医疗原因是感染或发热（17.6%），而最常见的管理原因和患者原因分别是时间不足（26.8%）和爽约（6.3%）。可避免的原因占64.8%，不可避免的原因占35.2%。在多变量分析中，风险因素包括年龄、班次、季节和手术科室。
手术取消会对物资和人力资源的消耗产生影响。为了提高医疗质量，任何降低其发生率的方法都应是我们未来的优先事项。
