手术室噪声与手术难度相吻合。

Noise in the operating room coincides with surgical difficulty.

机构信息

Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.

Institute of Work and Organisational Psychology, University of Neuchâtel, Neuchâtel, Switzerland.

出版信息

BJS Open. 2024 Sep 3;8(5). doi: 10.1093/bjsopen/zrae098.

DOI:10.1093/bjsopen/zrae098

PMID:39413049

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11482277/

Abstract

BACKGROUND

Noise in the operating room has been shown to distract the surgical team and to be associated with postoperative complications. It is, however, unclear whether complications after noisy operations are the result of objective or subjective surgical difficulty or the consequence of distraction of the operating room team by noise.

METHODS

Noise level measurements were prospectively performed during operations in four Swiss hospitals. Objective difficulty for each operation was calculated based on surgical magnitude as suggested by the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM), duration of operation and surgical approach. Subjective difficulty and distraction were evaluated by a questionnaire filled out by the operating room team members. Complications were assessed 30 days after surgery. Using regression analyses, the relationship between objective and subjective difficulty, distraction, intraoperative noise and postoperative complications was tested.

RESULTS

Postoperative complications occurred after 121 (38%) of the 294 procedures included. Noise levels were significantly higher in operations that were objectively and subjectively more difficult (59.89 versus 58.35 dB(A), P < 0.001) and operations that resulted in postoperative complications (59.05 versus 58.77 dB(A), P = 0.004). Multivariable regression analyses revealed that subjective difficulty as reported by all members of the surgical team, but not distraction, was highly associated with noise and complications. Only objective surgical difficulty independently predicted noise and postoperative complications.

CONCLUSION

Noise in the operating room is a surrogate of surgical difficulty and thereby predicts postoperative complications.

摘要

背景

手术室中的噪音已被证明会分散手术团队的注意力，并与术后并发症有关。然而，目前尚不清楚嘈杂手术后的并发症是由于客观或主观的手术难度引起的，还是由于手术室团队受到噪音干扰的结果。

方法

在瑞士的四家医院进行了前瞻性的手术室噪音水平测量。根据生理学和手术严重程度评分用于死亡率和发病率的计数（POSSUM），手术规模、手术持续时间和手术入路计算了每个手术的客观难度。通过手术室团队成员填写的问卷评估了主观难度和注意力分散情况。术后 30 天评估并发症。使用回归分析测试了客观和主观难度、注意力分散、术中噪音与术后并发症之间的关系。

结果

在 294 例手术中有 121 例（38%）发生了术后并发症。客观和主观上难度更大的手术（59.89 分贝（A）比 58.35 分贝（A），P<0.001）和导致术后并发症的手术（59.05 分贝（A）比 58.77 分贝（A），P=0.004）中的噪音水平显著更高。多变量回归分析显示，所有手术团队成员报告的主观难度而不是注意力分散与噪音和并发症高度相关。只有客观手术难度独立预测了噪音和术后并发症。