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The Operating Room management for emergency Surgical Activity (ORSA) study: a WSES international survey

  • 期刊论文

  • 发表日期：

    2024年1月8日

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  • Belinda De Simone,
  • Vanni Agnoletti,
  • Fikri M. Abu-Zidan,
  • Walter L. Biffl,
  • Ernest E. Moore,
  • Elie Chouillard,
  • Federico Coccolini,
  • Massimo Sartelli,
  • Mauro Podda,
  • Salomone Di Saverio,
  • Haytham Kaafarani,
  • Zsolt J. Balogh,
  • Miklosh Bala,
  • Ari K. Leppäniemi,
  • Andrew W. Kirkpatrick,
  • Emmanouil Pikoulis,
  • Kemal Rasa,
  • Chiara Rosato,
  • Robert Sawyer,
  • Luca Ansaloni,
  • Nicola de’Angelis,
  • Dimitris Damaskos,
  • Philip F. Stahel,
  • Yoram Kluger,
  • Raul Coimbra,
  • Ademola Adeyeye,
  • Adriana Toro,
  • adrien Hodonou,
  • Aintzane Lizarazu,
  • Aitor Landaluce-Olavarria,
  • Alberto Porcu,
  • Aleix Martínez-Pérez,
  • Anastasia Pikouli,
  • Andee Dzulkarnaen Zakaria,
  • Andrea Barberis,
  • Andrea Romanzi,
  • Andreas Hecker,
  • Andrey Litvin,
  • Anna Guariniello,
  • Arda Isik,
  • Aristeidis Papadopoulos,
  • Aristeidis Papadopoulos,
  • Aristotelis Kechagias,
  • Athanasios Marinis,
  • Boris E. Sakakushev,
  • Boyko Atanasov,
  • Boyko Atanasov,
  • Bruno Nardo,
  • Casoni Pattacini Gianmaria,
  • Charalampos Seretis,
  • Christos Chouliaras,
  • Christos Doudakmanis,
  • Claudia Zaghi,
  • Desire’ Pantalone,
  • Despina Kimpizi,
  • Diego Sasia,
  • Diego Visconti,
  • Dimitrios K Manatakis,
  • Dimitrios Papaconstantinou,
  • Dimitrios Schizas,
  • Edgar Fernando hernandez García,
  • Edward C. T. H. Tan,
  • Efstratia Baili,
  • Elena Ruiz-Úcar,
  • Elif Colak,
  • Emanuel Gois Jr.,
  • Emmanuel Schneck,
  • Enrico Pinotti,
  • Evgeni Dimitrov,
  • Fabrizio D’Acapito,
  • Felipe Alconchel,
  • Felipe Pareja,
  • Francesk Mulita,
  • Gabriela Nita,
  • Gennaro Martines,
  • Georgios Koukoulis,
  • Georgios Zacharis,
  • Giorgio Giraudo,
  • Giuseppe Brisinda,
  • Giuseppe Curro’,
  • Giuseppe Palomba,
  • Goran Augustin,
  • Igor A Kryvoruchko,
  • Imtiaz Wani,
  • Ionut Negoi,
  • Isidoro Di Carlo,
  • Justin Davies,
  • Kenneth Y. Y. Kok,
  • Koray Das,
  • Larysa Sydorchuk,
  • Leandro Siragusa,
  • Leonardo Solaini,
  • Lovenish Bains,
  • Luca Ferrario,
  • Luis Buonomo,
  • Luis Buonomo,
  • Mahir Gachabayov,
  • Mario D’Oria,
  • Mario V Papa,
  • Martin Reichert,
  • Massimiliano Veroux,
  • Matthias Hecker,
  • Matti Tolonen,
  • Mesina Cristian,
  • Michele Ammendola,
  • Mihail Slavchev,
  • Mirko Barone,
  • Musina Ana-Maria,
  • Nicola Cillara,
  • Nicolò Tamini,
  • Nikolaos Machairas,
  • Nikolaos Pararas,
  • Orestis Ioannidis,
  • Osvaldo Chiara,
  • Pietro Bisagni,
  • Raluca Bievel Radulescu,
  • Roberto Bini,
  • Ruslan Sydorchuk,
  • Selmy Awad,
  • Semra Demirli Atici,
  • Sharfuddin Chowdhury,
  • Silvia Severi,
  • Somprakas Basu,
  • Stefano Olmi,
  • Stefano Piero Bernardo Cioffi,
  • Tapan Patel,
  • Teresa Perra,
  • Timothy Craig Hardcastle,
  • Vasilescu Alin Mihai,
  • Victor Kong,
  • Vishal Shelat,
  • Vladimir Khokha,
  • Wagih Ghannam,
  • Yunfeng Cui,
  • Fausto Catena

摘要

Background

Despite advances and improvements in the management of surgical patients, emergency and trauma surgery is associated with high morbidity and mortality. This may be due in part to delays in definitive surgical management in the operating room (OR). There is a lack of studies focused on OR prioritization and resource allocation in emergency surgery. The Operating Room management for emergency Surgical Activity (ORSA) study was conceived to assess the management of operating theatres and resources from a global perspective among expert international acute care surgeons.

Method

The ORSA study was conceived as an international web survey. The questionnaire was composed of 23 multiple-choice and open questions. Data were collected over 3 months. Participation in the survey was voluntary and anonymous.

Results

One hundred forty-seven emergency and acute care surgeons answered the questionnaire; the response rate was 58.8%. The majority of the participants come from Europe. One hundred nineteen surgeons (81%; 119/147) declared to have at least one emergency OR in their hospital; for the other 20/147 surgeons (13.6%), there is not a dedicated emergency operating room. Forty-six (68/147)% of the surgeons use the elective OR to perform emergency procedures during the day. The planning of an emergency surgical procedure is done by phone by 70% (104/147) of the surgeons.

Conclusions

There is no dedicated emergency OR in the majority of hospitals internationally. Elective surgical procedures are usually postponed or even cancelled to perform emergency surgery. It is a priority to validate an effective universal triaging and scheduling system to allocate emergency surgical procedures. The new Timing in Acute Care Surgery (TACS) was recently proposed and validated by a Delphi consensus as a clear and reproducible triage tool to timely perform an emergency surgical procedure according to the clinical severity of the surgical disease. The new TACS needs to be prospectively validated in clinical practice. Logistics have to be assessed using a multi-disciplinary approach to improve patients' safety, optimise the use of resources, and decrease costs.