Sherlock D J, Randle J, Playforth M, Cox R, Holl-Allen R T
Br Med J (Clin Res Ed). 1984 Jul 21;289(6438):170-1. doi: 10.1136/bmj.289.6438.170.
A prospective study of emergency operations was performed over three months in a district general hospital. Before starting surgery surgeons completed a questionnaire recording clinical details together with time of admission and were asked to state whether in their opinion the case could be safely deferred until the next morning assuming operating time was available. Of 251 operations performed, forms were completed for 244. According to the surgeons, 62 could have been safely deferred, and subsequent independent analysis indicated a further 24 could also have been safely postponed, giving a total of 86 cases (35%). Of the remainder, 71 were started between 2300 and 0900, and of these 51 (71%) were major operations requiring an experienced surgeon. The results suggest that, although the volume of nocturnal major surgery could not be reduced, the introduction of a daily emergency theatre session for cases seen during the day and those which could be deferred from the previous night would appreciably reduce the overall workload of nocturnal surgery at present done by the resident junior staff. This study will have important implications if, as has been suggested, the number of junior medical staff on call at night for emergencies is reduced.
在一家区综合医院进行了为期三个月的急诊手术前瞻性研究。在开始手术前，外科医生完成一份记录临床细节以及入院时间的问卷，并被要求说明他们是否认为在有手术时间的情况下，该病例可以安全地推迟到第二天早上。在进行的251例手术中，完成了244份表格。根据外科医生的判断，62例手术可以安全地推迟，随后的独立分析表明另有24例也可以安全地推迟，共计86例（35%）。其余病例中，71例在23:00至09:00之间开始手术，其中51例（71%）是需要经验丰富的外科医生进行的大手术。结果表明，尽管夜间大手术的数量无法减少，但为白天就诊的病例以及前一晚可推迟的病例安排每日急诊手术室时段，将显著减少目前由住院初级 staff 进行的夜间手术的总体工作量。如果如所建议的那样减少夜间待命处理紧急情况的初级医务人员数量，这项研究将具有重要意义。
