Surgical quality in organ procurement during day and night: an analysis of quality forms.
Surgical quality in organ procurement during day and night: an analysis of quality forms.
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DOI：
10.1136/bmjopen-2018-022182
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发表时间：
2018-11-25
期刊：
影响因子：
2.9
通讯作者：
Braat AE
中科院分区：
文献类型：
--
作者：
de Boer JD;Van der Bogt KEA;Putter H;Ooms-de Vries KM;Haase-Kromwijk BJJM;Pol RA;De Jonge J;Dejong CHC;Nijboer WM;Van der Vliet JA;Braat AE
分析手术质量与手术时间之间的潜在关系。对获取和接受已故供体器官的外科医生填写的全套质量表格进行回顾性分析。荷兰的采购程序是按地区组织的。所有程序都由一个与该区域的学术医疗中心有联系的独立、专门的采购小组执行。在18个月的时间里，荷兰接受并获得了771个器官。其中，17个器官在运输前已退化，因此被排除在外。其余754个器官，填写表格591套（78%）（获取和移植）。基线特征在白天和晚上/夜间均具有可比性，但身高除外（p=0.003）。回顾性分析所有完整的质量表的主要结果，采购相关的手术损伤。根据采集的开始时间进行器官分类：白天（8:00-17:00）或晚上/夜间（17:00-8:00）。在591个器官中，129个器官（22%）是在白天获得的，462个器官（78%）是在晚上或夜间获得的。白天手术损伤发生率明显较低；22个器官（17%）与126个器官（27%）在夜间获得（p=0.016）。在考虑混杂因素后，这种关联仍然存在。这项研究表明，与白天相比，夜间手术中采购相关手术损伤的发生率增加。一天中的时间可能（在）直接影响手术性能，应考虑器官获取过程中损伤的潜在风险因素。
To analyse a potential association between surgical quality and time of day. A retrospective analysis of complete sets of quality forms filled out by the procuring and accepting surgeon on organs from deceased donors. Procurement procedures in the Netherlands are organised per region. All procedures are performed by an independent, dedicated procurement team that is associated with an academic medical centre in the region. In 18 months’ time, 771 organs were accepted and procured in The Netherlands. Of these, 17 organs were declined before transport and therefore excluded. For the remaining 754 organs, 591 (78%) sets of forms were completed (procurement and transplantation). Baseline characteristics were comparable in both daytime and evening/night-time with the exception of height (p=0.003). All complete sets of quality forms were retrospectively analysed for the primary outcome, procurement-related surgical injury. Organs were categorised based on the starting time of the procurement in either daytime (8:00–17:00) or evening/night-time (17:00–8:00). Out of 591 procured organs, 129 organs (22%) were procured during daytime and 462 organs (78%) during evening/night-time. The incidence of surgical injury was significantly lower during daytime; 22 organs (17%) compared with 126 organs (27%) procured during evening/night-time (p=0.016). This association persists when adjusted for confounders. This study shows an increased incidence of procurement-related surgical injury in evening/night-time procedures as compared with daytime. Time of day might (in)directly influence surgical performance and should be considered a potential risk factor for injury in organ procurement procedures.
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影响因子：
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