McDonald Michael, Ward Lawrence, Wortham Heather, Sorenson Breanna, Jarski Robert, El-Yussif Eddie
Department of Orthopaedic Surgery Henry Ford Macomb Hospital, Clinton Township, MI.
Michigan State University College of Osteopathic Medicine, Lansing, MI; and.
J Orthop Trauma. 2021 May 1;35(5):245-251. doi: 10.1097/BOT.0000000000001966.
To assess the outcomes of elderly hip fracture surgeries performed 12 months before and 12 months after the implementation of a daily 6 am-9 am dedicated orthopaedic trauma room (DOTR) at a Level II community trauma center.
Retrospective cohort study.
Level II academic trauma center.
A total of 431 consecutive trauma patients undergoing surgical management of isolated low-energy hip fractures from January 1, 2018, to December 31, 2019.
Implementation of a 6 am-9 am DOTR Monday through Friday.
Time to surgery, number of cases performed after hours, surgical time, 90-day morbidity and mortality, and time to therapy.
Retrospective analysis showed that despite a 24% increase in surgical hip fracture volume, implementation of a part-time DOTR led to a decrease in after-hours surgery (32.4% vs. 19.6%; P = 0.008) and patients requiring the intensive care unit postoperatively (7% vs. 3.8%; P = 0.036). Surgeries performed after hours were longer than that of surgeries performed during the daytime (82.0 vs. 68 minutes; P = 0.003) and had more complications (pneumonia, pulmonary embolism, and surgical site infection; P = 0.002, 0.047, 0.024, respectively).
Our results show that a part-time DOTR in a community Level II hospital is associated with improvement in patient care.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
评估在一家二级社区创伤中心实施每日上午6点至9点的专用骨科创伤室（DOTR）之前12个月和之后12个月进行的老年髋部骨折手术的结果。
回顾性队列研究。
二级学术创伤中心。
2018年1月1日至2019年12月31日期间共431例连续接受孤立性低能量髋部骨折手术治疗的创伤患者。
周一至周五上午6点至9点实施DOTR。
手术时间、非工作时间进行的病例数、手术时长、90天发病率和死亡率以及治疗时间。
回顾性分析显示，尽管髋部骨折手术量增加了24%，但实施兼职DOTR导致非工作时间手术减少（32.4%对19.6%；P = 0.008）以及术后需要入住重症监护病房的患者减少（7%对3.8%；P = 0.036）。非工作时间进行的手术比白天进行的手术时间更长（82.0分钟对68分钟；P = 0.003），且并发症更多（肺炎、肺栓塞和手术部位感染；P分别为0.002、0.047和0.024）。
我们的结果表明，社区二级医院的兼职DOTR与患者护理的改善相关。
治疗性三级。有关证据级别的完整描述，请参阅作者指南。
