A-Lai Gu-Ha, Hu Jian-Rong, Xu Zhi-Jie, Yao Peng, Zhong Xia, Wang Yu-Cheng, Lin Yi-Dan
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.
Operating Room of Anesthesia Surgery Center, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China.
Front Surg. 2022 Aug 24;9:922198. doi: 10.3389/fsurg.2022.922198. eCollection 2022.
Fatigue and the long work hours of surgeons have attracted increasing concern in recent years. We aimed to explore whether starting time was associated with perioperative outcomes and cost for elective lung surgery.
A retrospective study was conducted on elective lung surgery patients at a high surgery-volume center between September 2019 and November 2019. Patients were divided into the "early start group" if the surgery start time was before 4 post meridiem (pm), while the "late start group" was defined as surgery started after 4 pm. Perioperative outcomes and total hospital costs were compared between the two groups. In addition, multivariable logistic regression analysis was performed to identify whether start time was a risk factor for postoperative hospital duration, total hospital cost and length of operation time.
A total of 398 patients were finally enrolled for analysis in this study. Of all the cases, 295 patients were divided into the early start group, while 103 patients belonged to the late start group. Baseline characteristics were all comparable between the two groups. Concerning Regarding outcomes, there were no differences in postoperative hospital duration, operation time, complication incidence or and other outcomes, while the total hospital cost tended to be different but still not significantly different without statistical significance (= 0.07). In multivariable logistic regression analysis, surgery starting late was still not found to be a risk factor for long postoperative hospital duration, high hospital cost and long surgery time.
In elective lung surgery, perioperative outcomes and costs were similar between the early- and late-start groups, and it was not necessary to worry about the surgery order for these patients.
近年来，外科医生的疲劳和长时间工作受到了越来越多的关注。我们旨在探讨择期肺手术的开始时间是否与围手术期结局及费用相关。
对2019年9月至2019年11月在一家高手术量中心接受择期肺手术的患者进行回顾性研究。如果手术开始时间在下午4点之前，则将患者分为“早开始组”，而“晚开始组”定义为手术在下午4点之后开始。比较两组的围手术期结局和总住院费用。此外，进行多变量逻辑回归分析，以确定开始时间是否是术后住院时间、总住院费用和手术时间长度的危险因素。
本研究最终共纳入398例患者进行分析。在所有病例中，295例患者被分为早开始组，103例患者属于晚开始组。两组的基线特征均具有可比性。关于结局，术后住院时间、手术时间、并发症发生率及其他结局方面均无差异，而总住院费用虽有差异趋势但仍无统计学意义（P = 0.07）。在多变量逻辑回归分析中，仍未发现手术开始时间晚是术后住院时间长、住院费用高和手术时间长的危险因素。
在择期肺手术中，早开始组和晚开始组的围手术期结局和费用相似，无需担心这些患者的手术顺序。
