Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, AE211, Harry Medovy House, 671 William Avenue, Winnipeg, MB, R3E 0Z2, Canada.
Department of Psychology, Faculty of Arts, University of Manitoba, Winnipeg, Canada.
Can J Anaesth. 2021 Mar;68(3):315-323. doi: 10.1007/s12630-020-01824-z. Epub 2020 Oct 21.
Worldwide, patients experience difficulties accessing elective surgical care. This study examined the perceived health, social, and functional impacts of elective surgical cancellations and postponements in Canada.
We analyzed a subset of aggregate data from the Canadian Community Health Survey (CCHS) annual components from 2005 to 2014. Multivariable logistic regressions examined associations between past-year non-emergency surgical cancellations/postponements and perceived impacts of waiting for surgery (e.g., worry/stress/anxiety, pain, loss of work, loss of income, deterioration of health, relationships suffered).
Among those who experienced a cancellation or postponement of a past-year non-emergency surgery (weighted n = 256,836; 11.8%), 23.5% (weighted n = 60,345) indicated their life was affected by waiting for surgery. After adjusting for type of surgery, year, and sociodemographics, those who experienced a surgical cancellation or postponement had increased odds of reporting their life was affected by waiting for surgery (adjusted odds ratio [aOR], 2.67; 99% confidence interval [CI], 1.41 to 5.1); in particular, they reported greater deterioration of their health (aOR, 3.47; 99% CI, 1.05 to 11.4) and increased dependence on relatives/friends (aOR, 2.53; 99% CI, 1.01 to 6.3) than those who did not have a cancellation or postponement.
Results highlight the multifaceted perceived impacts of surgical cancellations/postponements. These findings suggest there is a need for improvements in reducing elective surgical cancellations and postponements. Results may also inform the development of targeted interventions to improve patients' health and quality of life while waiting for surgery.
在全球范围内,患者在获得择期手术治疗方面存在困难。本研究调查了加拿大择期手术取消和推迟对患者健康、社会和功能的感知影响。
我们分析了 2005 年至 2014 年加拿大社区健康调查(CCHS)年度综合数据的一个子集。多变量逻辑回归分析了过去一年非紧急手术取消/推迟与等待手术的感知影响(例如,担忧/压力/焦虑、疼痛、丧失工作、收入损失、健康恶化、人际关系受损)之间的关联。
在过去一年非紧急手术取消/推迟的人群中(加权 n=256836;11.8%),23.5%(加权 n=60345)表示他们的生活受到了等待手术的影响。在调整了手术类型、年份和社会人口统计学因素后,经历手术取消或推迟的患者报告其生活受到等待手术影响的可能性增加(调整后的优势比[aOR],2.67;99%置信区间[CI],1.41 至 5.1);特别是,他们报告健康状况恶化(aOR,3.47;99%CI,1.05 至 11.4)和对亲戚/朋友的依赖增加(aOR,2.53;99%CI,1.01 至 6.3)的可能性高于未取消或推迟手术的患者。
研究结果强调了手术取消/推迟的多方面感知影响。这些发现表明,需要改善减少择期手术取消和推迟的措施。研究结果还可能为制定有针对性的干预措施提供信息,以改善患者在等待手术期间的健康和生活质量。