McLean Keri, Ferrara Mariantonia, Kaye Rebecca, Romano Vito, Kaye Stephen
Department of Eye and Vision Science, University of Liverpool Faculty of Health and Life Sciences, Liverpool, UK.
Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
BMJ Open Ophthalmol. 2021 Oct 22;6(1):e000809. doi: 10.1136/bmjophth-2021-000809. eCollection 2021.
Order of the theatre list and complexity of the cases are important considerations which are known to influence surgical outcomes. This survey aimed to establish their influence on cataract surgery.
Cataract surgeons ordered five cataract cases according to their surgical preference, first using case notes and second using composite ORs (CORs) for posterior capsule rupture. Descriptive and non-parametric statistics were used to analyse the data.
Between 11 June and 14 July 2020, 192 cataract surgeons from 14 countries completed the online survey. Majority of the surgeons (142 vs 50) preferred to choose the order of their list (p<0.01) and to review the case notes prior to the day of surgery (89 vs 53; p=0.04). 39.86% preferred to start with the less risky case and 32.43% reserved the last position on the list for the riskiest case. There was a significant trend to order the list in an ascending level of risk, independent of whether case notes or CORs were used. Additionally, 44.79% of the respondents indicated they would be happy to have their list order planned by an automated program based on their preferred risk score.
This survey demonstrates that cataract surgeons prefer to choose the order of their theatre list and that the order is dependent on the complexity of cases. There is support among surgeons for automated list ordering based on an objective score for risk stratification, such as a COR.
手术排期顺序及病例复杂性是已知会影响手术结果的重要考量因素。本调查旨在确定它们对白内障手术的影响。
白内障手术医生根据自己的手术偏好对五例白内障病例进行排序，先是查看病历，然后使用后囊破裂综合手术风险值（COR）进行排序。采用描述性和非参数统计方法分析数据。
在2020年6月11日至7月14日期间，来自14个国家的192名白内障手术医生完成了在线调查。大多数手术医生（142人对50人）更倾向于选择自己的排期顺序（p<0.01），并在手术当天之前查看病历（89人对53人；p=0.04）。39.86%的人倾向于先处理风险较低的病例，32.43%的人将名单上的最后一个位置留给风险最高的病例。无论使用病历还是COR，都存在按风险等级升序排列名单的显著趋势。此外，44.79%的受访者表示，他们愿意让一个基于其偏好风险评分的自动化程序来安排他们的排期顺序。
本次调查表明，白内障手术医生倾向于选择自己的手术排期顺序，且排期顺序取决于病例的复杂性。手术医生支持基于客观风险分层评分（如COR）的自动化排期。
