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A Prospective Evaluation of the Utility of a Hybrid Operating Suite for Severely Injured Patients: Overstated or Underutilized?
Carver, David; Kirkpatrick, Andrew W; D'Amours, Scott; Hameed, S Morad; Beveridge, Julie; Ball, Chad G.
Afiliação
  • Carver D; Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Kirkpatrick AW; Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • D'Amours S; Liverpool Hospital, Sydney, Australia.
  • Hameed SM; University of British Columbia, Vancouver, BC, Canada.
  • Beveridge J; Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Ball CG; Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Ann Surg ; 271(5): 958-961, 2020 05.
Article em En | MEDLINE | ID: mdl-30601253
OBJECTIVE: The primary objective of this study was to evaluate the utility, clinical impact, and work flow of a new trauma hybrid operating theater. SUMMARY BACKGROUND DATA: The potential utility and clinical benefit of hybrid operating theaters are increasingly postulated. Unfortunately, the clinical outcomes and efficiencies of these environments remain unclear. METHODS: All severely injured patients who were transferred to the hybrid suite for emergent intervention between 2013 and 2017 were compared to consecutive prehybrid patients. Standard statistical methodology was employed (P < 0.05 = significant). RESULTS: One hundred sixty-nine patients with severe injuries (mean ISS = 23; hemodynamic instability = 70%; hospital/ICU stay = 12 d; mortality = 14%) were transferred urgently to the hybrid suite. Most were young (38 yrs) males (84%) with blunt injuries (51%). Combined hybrid trauma procedures occurred in 18% of cases (surgery (82%) and angiography (11%) alone). Procedures within the hybrid suite included: laparotomy (57%), extremity (14%), thoracotomy/sternotomy (12%), angioembolization of the spleen/pelvis/liver/other (9%), neck (9%), craniotomy (4%), and aortic endostenting (6%). Compared with historical controls, use of the hybrid suite resulted in shorter arrival to intervention and total procedure times (P < 0.05). A clear benefit for survival was evident (42% vs. 22%). CONCLUSIONS: Availability of a hybrid environment for severely injured patients reduces time to intervention, total procedural duration, blood product transfusion and salvages a small subset of patients who would not otherwise survive. The cost associated with a hybrid suite remains prohibitive for many centers.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Salas Cirúrgicas / Ferimentos e Lesões / Avaliação de Resultados em Cuidados de Saúde / Ambiente de Instituições de Saúde Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Revista: Ann Surg Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Salas Cirúrgicas / Ferimentos e Lesões / Avaliação de Resultados em Cuidados de Saúde / Ambiente de Instituições de Saúde Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Revista: Ann Surg Ano de publicação: 2020 Tipo de documento: Article