Surgical Emergency Flows and Delays in Admission to the Operating Room

Overview

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.

Conditions

Eligibility