Kocaman Mesut, Johnston Stephen, Afolabi Mosadoluwa, Danker Walter, Adshead Fiona
Johnson & Johnson MedTech, Berkshire, UK.
Johnson & Johnson MedTech, New Brunswick, NJ, USA.
Surg Open Sci. 2025 Apr 29;26:54-60. doi: 10.1016/j.sopen.2025.04.009. eCollection 2025 Jun.
Minimizing avoidable healthcare resource use can support a move towards more sustainable healthcare systems. Few studies have sought to evaluate the environmental impact of complications associated with specific surgical procedures. The aim of this study was to assess the environmental impact associated with disruptive surgical bleeding across a broad range of procedures.
The environmental impact assessment was performed using clinical and healthcare resource use data from a retrospective database analysis of patients with disruptive bleeding across nine procedures. Emissions data from the Sustainable Healthcare Coalition were sourced for the relevant resource use activities and used to calculate the climate, water and waste impact associated with disruptive surgical bleeding.
Across the procedures of interest, surgical bleeding was shown to incur a mean environmental impact of 167 kg COe, 267 m water use and 20 kg waste. Considering the incidence of disruptive bleeding per 1000 procedures, treatment of bleeding during valve procedures was associated with the highest environmental impact due to the high proportion of patients in which this complication occurs (44 %). Achieving effective and timely control of surgical bleeding events and reducing their incidence by 50 % could save up to 49 tons of CO₂e, 77,082 m of water use, and 6.3 tons of waste per 1000 surgical procedures.
Surgical bleeding is associated with a substantial environmental impact. This study demonstrates the potential to use existing resource use data associated with specific healthcare activities to assess their environmental impact, helping to identify key areas for improvement in the sustainability of surgical departments.
尽量减少可避免的医疗资源使用有助于推动医疗系统向更可持续的方向发展。很少有研究试图评估特定外科手术相关并发症对环境的影响。本研究的目的是评估一系列手术中手术出血造成的环境影响。
使用来自对九种手术中出现手术出血的患者进行回顾性数据库分析的临床和医疗资源使用数据进行环境影响评估。从可持续医疗联盟获取相关资源使用活动的排放数据，并用于计算与手术出血相关的气候、水和废物影响。
在感兴趣的手术中，手术出血显示平均产生167千克二氧化碳当量的环境影响、267立方米的水消耗和20千克的废物。考虑到每1000例手术中手术出血的发生率，瓣膜手术中出血的治疗对环境的影响最大，因为发生这种并发症的患者比例很高（44%）。有效及时地控制手术出血事件并将其发生率降低50%，每1000例手术最多可节省49吨二氧化碳当量、77082立方米的水消耗和6.3吨的废物。
手术出血对环境有重大影响。本研究表明，利用与特定医疗活动相关的现有资源使用数据来评估其环境影响具有潜力，有助于确定外科科室可持续性改进的关键领域。
