Prone positioning in the elderly extends perioperative process times: a retrospective analysis

GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW

Schnoor, Joerg¹  Busch, Thilo²  Niese-Anke, Mary²  Friese, Steffen²  Heyde, Christoph E.³  Jarvers, Jan-S.³ 

[1] Department of Anaesthesia and Intensive Care Medicine, Collm Klinik Oschatz, Germany;Department of Anaesthesia and Intensive Care Medicine, University Hospital Leipzig, Germany;Department of Orthopaedics, Trauma Surgery and Reconstructive Surgery, University Hospital Leipzig, Germany;

关键词: elderly;    demographic change;    cervical fracture;    process times;    patient positioning;   

DOI  :  10.3205/iprs000126

来源: DOAJ

【 摘 要 】

Objective: Cervical bone fractures describe a predominant trauma in the elderly. With demographic change, prone patient positions might create further stress on personnel resources. Therefore, the aim of this study was to conduct an age-related analysis of pre- and intraoperative process times in patients with cervical fractures.Methods: We reviewed all schedules with cervical spine surgery performed at a tertiary hospital. Two different operative patient positions were specified: prone and supine. We retrospectively analysed three study groups: comparison group (group 1: ≤59 years of age), old patients (group 2: 60–79 years), and very old patients (group 3: ≥80 years). We recorded date and kind of surgery, biometric data, and process times by screening recordings of internal software programs (COPRA and SAP 710). Group comparisons were conducted using the Kruskal-Wallis test with Dunn’s post hoc test and Bonferroni correction,chi-square test, and the Mann-Whitney U test, as required. Results: 330 patients (202 male; 128 female) were analysed. The number of patients in the resulting age-dependent groups 1–3 were n=102, n=123, and n=105, respectively. Patients of increasing age and in supine position showed a continuous increase in the time needed for anaesthesia induction (mean between 4 and 8 minutes (p<0.05). When compared to patients in supine position, this time further increased on average by 6 minutes (p<0.05) in old but prone patients. In old and very old patients, getting a patient into a prone position was associated with a time demand between 10 and 12 minutes (p<0.01), respectively. While time for surgery age-dependently decreased in patients that were supine positioned (p<0.001), surgery time was prolonged between 34 and 104 minutes (p<0.05) in patients that were prone. Conclusion: With prone position both anaesthesia-controlled and surgical-controlled times extended in patients of increasing age. With regard to demographic change, this aspect should be considered for future revenue calculations in flat-rate remuneration systems.

【 授权许可】

Unknown