From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ont. (Saggaf, Novak, Baltzer, Anastakis); the Hand Program, Toronto Western Hospital, University Health Network, Toronto, Ont. (Saggaf, Baltzer, Anastakis); the Institute of Medical Science, University of Toronto, Toronto, Ont. (Saggaf, Anastakis); the Division of Plastic and Reconstructive Surgery, Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia (Saggaf); and the Krembil Research Institute, University Health Network, Toronto, Ont. (Anastakis).
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ont. (Saggaf, Novak, Baltzer, Anastakis); the Hand Program, Toronto Western Hospital, University Health Network, Toronto, Ont. (Saggaf, Baltzer, Anastakis); the Institute of Medical Science, University of Toronto, Toronto, Ont. (Saggaf, Anastakis); the Division of Plastic and Reconstructive Surgery, Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia (Saggaf); and the Krembil Research Institute, University Health Network, Toronto, Ont. (Anastakis)
Can J Surg. 2021 Nov 25;64(6):E636-E643. doi: 10.1503/cjs.011920. Print 2021 Nov-Dec.
To better understand the occurrence and operative treatment of peripheral nerve injury (PNI) and the potential need for additional resources, it is essential to define the frequency and distribution of peripheral nerve procedures being performed. The objective of this study was to evaluate Ontario's wait times for delayed surgical treatment of traumatic PNI.
We retrieved data on wait times for peripheral nerve surgery from the Ontario Ministry of Health and Long-Term Care Wait Time Information System. We reviewed the wait times for delayed surgical treatment of traumatic PNI among adult patients (age ≥ 18 yr) from April 2009 to March 2018. Data collected included total cases, mean and median wait times, and demographic characteristics.
Over the study period, 7313 delayed traumatic PNI operations were reported, with variability in the case volume distribution across Local Health Integration Networks (LHINs). The highest volume of procedures (2788) was performed in the Toronto Central LHIN, and the lowest volume (< 6) in the Waterloo Wellington and North Simcoe Muskoka LHINs. The population incidence of traumatic PNI requiring surgery was 5.1/10 000. The mean and median wait times from surgical decision to surgical repair were 45 and 27 days, respectively. Both the longest and shortest wait times occurred in LHINs with low case volumes. The provincial target wait time was met in 93% of cases, but women waited significantly longer than men ( < 0.001).
The provincial distribution of traumatic PNI surgery was variable, and the highest volumes were in the LHINs with large populations. The provincial wait time strategy for traumatic PNI surgery is effective, but women waited longer than men. Precise reporting from all hospitals is necessary to accurately capture and understand the delivery of care after traumatic PNI.
为了更好地了解周围神经损伤（PNI）的发生和手术治疗情况，以及是否需要额外的资源，明确正在进行的周围神经手术的频率和分布至关重要。本研究的目的是评估安大略省外伤性 PNI 延迟手术治疗的等待时间。
我们从安大略省卫生部和长期护理等待时间信息系统中检索了周围神经手术的等待时间数据。我们回顾了 2009 年 4 月至 2018 年 3 月期间成年患者（年龄≥18 岁）外伤性 PNI 延迟手术治疗的等待时间。收集的数据包括总病例数、平均和中位数等待时间以及人口统计学特征。
在研究期间，报告了 7313 例外伤性 PNI 延迟手术，各地区卫生整合网络（LHIN）之间的病例量分布存在差异。手术量最高（2788 例）的是多伦多中心 LHIN，手术量最低（<6 例）的是滑铁卢惠灵顿和北西蒙斯莫克卡 LHIN。需要手术治疗的外伤性 PNI 的人群发病率为 5.1/10000。从手术决策到手术修复的平均和中位数等待时间分别为 45 天和 27 天。最长和最短的等待时间都发生在手术量低的 LHIN。93%的病例达到了省级目标等待时间，但女性的等待时间明显长于男性（<0.001）。
外伤性 PNI 手术的省级分布存在差异，且手术量最高的是人口较多的 LHIN。外伤性 PNI 手术的省级等待时间策略是有效的，但女性的等待时间长于男性。所有医院都需要准确报告，以便准确捕捉和了解外伤性 PNI 后的护理情况。
