Emergencies, Postoperative Complications, Surgery
Conditions
Keywords
delay, organization
Brief summary
French hospitals treat non-elective surgery according to three organizational models: in a dedicated multi-specialty emergency operative room (OR), in a dedicated OR within a specialized surgical platform or in any available OR from a list of non-dedicated OR. Some triage algorithms for the classification of non-elective surgery have been described but are not routinely applied. The rate of delay in the management of non-elective surgery in France is not known. Reducing this delay decreased mortality and morbidity in urgent surgery (McIsaac D, et al., CMAJ 2017). Optimizing the flow of non-elective surgery represents a major challenge. The main objective of this study is to determine the rate of delay in admission to the OR in emergency surgery through a multicenter prospective observational study in France. All patients requiring urgent surgical management (\<72 hours) will be included. The ideal time for surgery was previously defined by surgeons according to the NEST classification (NEST 1: within minutes; NEST 2: \< 1 hour; NEST 3: \< 4 hours; NEST 4: \< 12 hours; NEST 5: \< 48 hours; NEST 6: \< 72 hours). For each patient, the ratio between the observed time (actual Time To Surgery \[aTTS\] ) and the ideal time (ideal Time To Surgery \[iTTS\]) will be determined. The delay is identified by aTTS/iTTS ratio \>1.
Interventions
None listed
Sponsors
Société Française d'Anesthésie et de Réanimation
University Hospital, Lille
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
any patient meeting the Following two criteria * at least 18 ys old * decision for unplanned surgery (which should be performed within 72 hours according to the protocol) * in one of the following hospitals: Lille University hospital, Grenoble University hospital, Strasbourg University hospital, Paris University hospitals (Européen Georges Pompidou, Beaujon, H. Mondor), Lyon University hospital (Hôpital E. Herriot, Lyon Sud), Angers University hospital, Anthony Private hospital).
Exclusion criteria
* obstetrics * interventional radiology * endoscopies
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of OR admission delay (delay = aTTS / iTTS > 1) | 30 days | hours |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| OR Admission delay according to the period of work (day, night, and week-end) | 30 days | hours |
| OR Admission delay according to the NEST classification | 30 days | hours |
| delays related to organisational causes | 30 days | hours |
| delays related to material causes | 30 days | hours |
| OR Admission delay according to the three organizational model | 30 days | hours |
| Impact of the delay on ICU length of stay | 30 days | days |
| Impact of the delay on hospital length of stay | 30 days | days |
| Impact of the delay on mortality | 30 days | — |
| Impact of the delay on morbidity | 30 days | — |
| delays related to human causes | 30 days | hours |
Countries
France
Outcome results
None listed