Patient-specific Predictors of Surgical Delay in a Large Tertiary-care Hospital Operating Room.

Autor: Meyers N; Program of Nurse Anesthesia, University of Southern California, Los Angeles, CA. Electronic address: nmeyers@usc.edu., Giron SE; Kaiser Permanente School of Anesthesia, Pasadena, CA., Bush RA; Hahn School of Nursing and Health Science, University of San Diego, San Deigo, CA., Burkard JF; Hahn School of Nursing and Health Science, University of San Diego, San Deigo, CA.
Jazyk: angličtina
Zdroj: Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses [J Perianesth Nurs] 2024 Feb; Vol. 39 (1), pp. 116-121. Date of Electronic Publication: 2023 Oct 13.
DOI: 10.1016/j.jopan.2023.07.011
Abstrakt: Purpose: The purpose of this study was to describe patient-specific factors predictive of surgical delay in elective surgical cases.
Design: Retrospective cohort study.
Methods: Data were extracted retrospectively from the electronic health record of 32,818 patients who underwent surgery at a large academic hospital in Los Angeles between May 2012 and April 2017. Following bivariate analysis of patient-specific factors and surgical delay, statistically significant predictors were entered into a logistic regression model to determine the most significant predictors of surgical delay.
Findings: Predictors of delay included having monitored anesthesia care (odds ratio [OR], 1.28; 95% confidence intervals [CI], 1.20-1.36), American Society of Anesthesiologist class 3 or above (OR, 1.21; 95% CI, 1.15-1.28), African American race (OR, 1.25; 95% CI, 1.12-1.39), renal failure (OR, 1.20; 95% CI, 1.09-1.32), steroid medication (OR, 1.13; 95% CI, 1.04-1.23) and Medicaid (OR,1.18; 95%CI, 1.09-1.30) or medicare insurance (OR, 1.14; 95% CI, 1.07-1.21). Six surgical specialties also increased the odds of delay. Obesity and cardiovascular anesthesia decreased the odds of delay.
Conclusions: Certain patient-specific factors including type of insurance, health status, and race were associated with surgical delay. Whereas monitored anesthesia care anesthesia was predictive of a delay, cardiovascular anesthesia reduced the odds of delay. Additionally, obese patients were less likely to experience a delay. While the electronic health record provided a large amount of detailed information, barriers existed to accessing meaningful data.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 The American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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