Association of delay of urgent or emergency surgery with mortality and use of health care resources: a propensity score-matched observational cohort study.

Association of delay of urgent or emergency surgery with mortality and use of health care resources: a propensity score-matched observational cohort study. CMAJ. 2017 Jul 10;189(27):E905-E912 Authors: McIsaac DI, Abdulla K, Yang H, Sundaresan S, Doering P, Vaswani SG, Thavorn K, Forster AJ Abstract BACKGROUND: Delay of surgery for hip fracture is associated with increased risk of morbidity and mortality, but the effects of surgical delays on mortality and resource use in the context of other emergency surgeries is poorly described. Our objective was to measure the independent association between delay of emergency surgery and in-hospital mortality, length of stay and costs. METHODS: We identified all adult patients who underwent emergency noncardiac surgery between January 2012 and October 2014 at a single tertiary care centre. Delay of surgery was defined as the time from surgical booking to operating room entry exceeding institutionally defined acceptable wait times, based on a standardized 5-level priority system that accounted for surgery type and indication. Patients with delayed surgery were matched to those without delay using propensity scores derived from variables that accounted for details of admission and the hospital stay, patient characteristics, physiologic instability, and surgical urgency and risk. RESULTS: Of 15 160 patients, 2820 (18.6%) experienced a delay. The mortality rates were 4.9% (138/2820) ...
Source: cmaj - Category: General Medicine Authors: Tags: CMAJ Source Type: research