Surgical Emergency Flows and Delays in Admission to the Operating Room

Completed

• Conditions: Emergencies; Postoperative Complications; Surgery

• Registration Number: NCT04585529
• Lead Sponsor: University Hospital, Lille

Brief Summary

French hospitals treat non-elective surgery according to three organizational models: in a dedicated multi-specialty emergency operative room (OR), in a dedicated OR within a specialized surgical platform or in any available OR from a list of non-dedicated OR. Some triage algorithms for the classification of non-elective surgery have been described but are not routinely applied. The rate of delay in the management of non-elective surgery in France is not known. Reducing this delay decreased mortality and morbidity in urgent surgery (McIsaac D, et al., CMAJ 2017). Optimizing the flow of non-elective surgery represents a major challenge. The main objective of this study is to determine the rate of delay in admission to the OR in emergency surgery through a multicenter prospective observational study in France. All patients requiring urgent surgical management (\<72 hours) will be included. The ideal time for surgery was previously defined by surgeons according to the NEST classification (NEST 1: within minutes; NEST 2: \< 1 hour; NEST 3: \< 4 hours; NEST 4: \< 12 hours; NEST 5: \< 48 hours; NEST 6: \< 72 hours). For each patient, the ratio between the observed time (actual Time To Surgery \[aTTS\] ) and the ideal time (ideal Time To Surgery \[iTTS\]) will be determined. The delay is identified by aTTS/iTTS ratio \>1.

Detailed Description

Not available

Study Timeline

• Study Start: 2020-10-05
• Study First Submitted: 2020-10-05
• Study First Submitted QC: 2020-10-12
• Study First Posted: 2020-10-14
• Primary Completion: 2021-03-15
• Study Completion: 2021-03-15
• Status Verified: 2021-05
• Last Update Submitted: 2021-05-25
• Last Update Posted: 2021-05-26

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 1149

Inclusion Criteria

any patient meeting the Following two criteria

• at least 18 ys old
• decision for unplanned surgery (which should be performed within 72 hours according to the protocol)
• in one of the following hospitals: Lille University hospital, Grenoble University hospital, Strasbourg University hospital, Paris University hospitals (Européen Georges Pompidou, Beaujon, H. Mondor), Lyon University hospital (Hôpital E. Herriot, Lyon Sud), Angers University hospital, Anthony Private hospital).

Exclusion Criteria

• obstetrics
• interventional radiology
• endoscopies

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Incidence of OR admission delay (delay = aTTS / iTTS > 1)	30 days	hours

Secondary Outcome Measures

Name	Time	Method
delays related to organisational causes	30 days	hours
Impact of the delay on mortality	30 days
OR Admission delay according to the three organizational model	30 days	hours
OR Admission delay according to the NEST classification	30 days	hours
delays related to human causes	30 days	hours
Impact of the delay on morbidity	30 days
Impact of the delay on hospital length of stay	30 days	days
Impact of the delay on ICU length of stay	30 days	days
OR Admission delay according to the period of work (day, night, and week-end)	30 days	hours
delays related to material causes	30 days	hours

Trial Locations

Locations (8)

University Hospital; 🇫🇷 Strasbourg, France

Clinique; 🇫🇷 Antony, France

Henri Mondor Hospital; 🇫🇷 Créteil, France

Edouard Herriot Hospital; 🇫🇷 Lyon, France

Hôpital sud; 🇫🇷 Lyon, France

HEGP; 🇫🇷 Paris, France

Beaujon Hospital; 🇫🇷 Clichy, France

University hospital; 🇫🇷 Lille, France