July 9, 2017Canadian Medical Association JournalOpen Access

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

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Why the study?

Does delay of emergency surgery increase in-hospital mortality in adult patients undergoing emergency noncardiac surgery?

Structured PICO

Does delay of emergency surgery increase in-hospital mortality in adult patients undergoing emergency noncardiac surgery?

Population

15,160 adult patients who underwent emergency noncardiac surgery between January 2012 and October 2014 at a single tertiary care centre (The Ottawa Hospital)

Intervention

Delay of surgery (time from surgical booking to operating room entry exceeding institutionally defined acceptable wait times based on a 5-level priority system)

Comparator

No delay of surgery (reaching the operating room within an acceptable wait time)

Outcome

In-hospital mortalityhard clinical

Delayed operating room access for emergency noncardiac surgery is independently associated with an increased risk of in-hospital mortality, longer length of stay, and higher costs.

Limitations

Single-centre observational study cannot determine causality
Confounding and unmeasured covariables
Primary classification of delay was dichotomization of a continuous variable
Prioritization system not tested for effect on outcomes
Reported reasons for noncompliance missing for about 60% of patients
Cannot account for deaths outside the institution

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Delay of emergency noncardiac surgery was associated with higher mortality and costs; leaves open whether expedited pathways improve outcomes.

Cite This Study

McIsaac et al. (2017) studied this question.

synapsesocial.com/papers/6a736b199d7f0771de566599 https://doi.org/10.1503/cmaj.160576

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Implication

Delay of emergency noncardiac surgery was associated with higher mortality and costs; leaves open whether expedited pathways improve outcomes.

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

Structured PICO

Limitations

Discussion

Implication

Cite This Study

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

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider