Gebeyehu Geresu, Azene Denekew, Tesfaye Siryet
Department of Anesthesia, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Anesthesia, College of Medicine and Health Sciences, Debre Birhan University, Amhara, Ethiopia.
BMC Surg. 2025 Aug 9;25(1):360. doi: 10.1186/s12893-025-03047-9.
The delay in the starting of first elective surgical cases frequently occurs in the operation theatre. Its magnitude ranges from 24.8 to 99.3% and is contributed by many factors and it has the potential to induce major effects on the efficiency of the healthcare system.
To assess the magnitude and factors of delayed incision time of first cases among elective surgery at Tikur Anbessa Specialized Hospital, Addis Ababa Ethiopia, 2022/23.
A hospital-based cross-sectional study was conducted on 421 elective surgical first-cases in Tikur Anbessa Specialized Hospital, Addis Ababa Ethiopia, from January to April 28, 2023. The primary outcome of this study was the magnitude of delayed first cases' incision time of surgical patients. The data were collected using a structured questionnaire and systematic sampling method. Data was analyzed using statistical software for social sciences version 26. A chi-square test and logistic regression analysis were used for data analysis. Binary and multivariable logistic regression analysis was computed to determine the association between the independent and dependent variables. Independent variables with P < 0.20 were selected for multivariable analysis. Variables with P < 0.05 in a 95% confidence interval after multivariate analysis were selected as statistically significant.
a total of 924 cases were scheduled as the first cases in the study period and 422 cases were recruited. The magnitude of delayed first-case incision time was 56.5% with a mean delayance of 33 min. A multivariate analysis identified a lack of anesthesia and/or adjuvant drugs [AOR = 2.65(1.14-6.16), P < 0.05], late anesthesia induction [AOR = 19.65(10.07-38.34), P < 0.01], surgeons' or residents' late arrival to the operation theatre [AOR = 2.37(1.1-5.14), P < 0.05], surgical positions other than supine [AOR = 2.47(1.23-4.97), P < 0.05] and type of surgery as a significant predictors of delayed first case start of elective surgeries.
The magnitude of delayed first cases' incision time among elective surgery was high (56.5%) with a mean time of delayance of 33 min. Lack of anesthetics or adjuvants, late anesthesia induction, late arrival of the surgical team, surgical position other than supine, and surgery types were significantly associated factors. It is recommended to develop an improvement plan to minimize first-case incision time delayance and improve surgical efficiency among elective surgeries.
择期手术首个病例的开台延迟在手术室中经常发生。延迟幅度在24.8%至99.3%之间，由多种因素导致，并且有可能对医疗系统的效率产生重大影响。
评估2022/23年度埃塞俄比亚亚的斯亚贝巴提库尔·安贝萨专科医院择期手术中首个病例切口时间延迟的幅度及相关因素。
2023年1月至4月28日，在埃塞俄比亚亚的斯亚贝巴提库尔·安贝萨专科医院对421例择期手术首个病例进行了一项基于医院的横断面研究。本研究的主要结局是手术患者首个病例切口时间延迟的幅度。数据通过结构化问卷和系统抽样方法收集。使用社会科学统计软件第26版进行数据分析。采用卡方检验和逻辑回归分析进行数据分析。计算二元和多变量逻辑回归分析以确定自变量和因变量之间的关联。选择P<0.20的自变量进行多变量分析。多变量分析后在95%置信区间内P<0.05的变量被选为具有统计学意义。
在研究期间，共有924例病例被安排为首个病例，422例被纳入研究。首个病例切口时间延迟幅度为56.5%，平均延迟33分钟。多变量分析确定麻醉和/或辅助药物缺乏[AOR=2.65(1.14 - 6.16)，P<0.05]、麻醉诱导延迟[AOR=19.65(10.07 - 38.34)，P<0.01]、外科医生或住院医师到达手术室较晚[AOR=2.37(1.1 - 5.14)，P<0.05]、非仰卧位手术体位[AOR=2.47(1.23 - 4.97)，P<0.05]以及手术类型是择期手术首个病例开始延迟的显著预测因素。
择期手术中首个病例切口时间延迟幅度较高（56.5%），平均延迟时间为33分钟。麻醉剂或辅助药物缺乏、麻醉诱导延迟、手术团队到达较晚、非仰卧位手术体位以及手术类型是显著相关因素。建议制定改进计划，以尽量减少首个病例切口时间延迟，提高择期手术的手术效率。
