手术室的噪音与手术难度相吻合。

IF 3.5 3区 医学 Q1 SURGERY
BJS Open Pub Date : 2024-09-03 DOI:10.1093/bjsopen/zrae098
Sarah Peisl, Daniel Sánchez-Taltavull, Hugo Guillen-Ramirez, Franziska Tschan, Norbert K Semmer, Martin Hübner, Nicolas Demartines, Simon G Wrann, Stefan Gutknecht, Markus Weber, Daniel Candinas, Guido Beldi, Sandra Keller
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引用次数: 0

摘要

背景:研究表明,手术室中的噪音会分散手术团队的注意力,并与术后并发症有关。然而,目前还不清楚噪音手术后的并发症是客观或主观手术困难的结果,还是噪音分散手术室团队注意力的结果:方法:在瑞士四家医院对手术过程中的噪音水平进行了前瞻性测量。每项手术的客观难度是根据降低死亡率和发病率的生理和手术严重程度评分(POSSUM)、手术持续时间和手术方法计算得出的。主观难度和注意力分散情况由手术室团队成员填写的问卷进行评估。术后 30 天对并发症进行评估。通过回归分析,检验了客观和主观难度、牵拉、术中噪音与术后并发症之间的关系:结果:在 294 例手术中,有 121 例(38%)发生了术后并发症。客观和主观难度较高的手术(59.89 对 58.35 dB(A),P < 0.001)以及导致术后并发症的手术(59.05 对 58.77 dB(A),P = 0.004)的噪音水平明显较高。多变量回归分析表明,手术团队所有成员报告的主观难度与噪音和并发症高度相关,而分心则不然。只有客观手术难度能独立预测噪音和术后并发症:结论:手术室噪音是手术难度的代用指标,因此可预测术后并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Noise in the operating room coincides with surgical difficulty.

Background: Noise in the operating room has been shown to distract the surgical team and to be associated with postoperative complications. It is, however, unclear whether complications after noisy operations are the result of objective or subjective surgical difficulty or the consequence of distraction of the operating room team by noise.

Methods: Noise level measurements were prospectively performed during operations in four Swiss hospitals. Objective difficulty for each operation was calculated based on surgical magnitude as suggested by the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM), duration of operation and surgical approach. Subjective difficulty and distraction were evaluated by a questionnaire filled out by the operating room team members. Complications were assessed 30 days after surgery. Using regression analyses, the relationship between objective and subjective difficulty, distraction, intraoperative noise and postoperative complications was tested.

Results: Postoperative complications occurred after 121 (38%) of the 294 procedures included. Noise levels were significantly higher in operations that were objectively and subjectively more difficult (59.89 versus 58.35 dB(A), P < 0.001) and operations that resulted in postoperative complications (59.05 versus 58.77 dB(A), P = 0.004). Multivariable regression analyses revealed that subjective difficulty as reported by all members of the surgical team, but not distraction, was highly associated with noise and complications. Only objective surgical difficulty independently predicted noise and postoperative complications.

Conclusion: Noise in the operating room is a surrogate of surgical difficulty and thereby predicts postoperative complications.

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来源期刊
BJS Open
BJS Open SURGERY-
CiteScore
6.00
自引率
3.20%
发文量
144
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