Plan B Forum

Patients whose emergency surgeries are delayed have higher risk of dying, Canadian study shows

Patients whose emergency surgeries are delayed due to a lack of operating room resources have an increased risk of death or a need for extra recovery time in hospital, a Canadian study suggests.

Researchers at the Ottawa Hospital found that patients who had delays getting surgery for serious injuries or life-threatening conditions such as a hip fracture, appendicitis or an aneurysm had a higher risk of dying compared to those who received more timely treatment.

The study, published Monday in the Canadian Medical Association Journal, showed that patients who didn’t get into the OR within a standard time frame for their condition had an almost 5 per cent risk of dying, compared to a 3.2 per cent risk for those whose surgeries weren’t delayed.

On average, delayed-surgery patients also stayed in hospital after their operation 1.1 days longer and cost the hospital $1,409 more than patients who did not have to wait.

“For the first time, we have strong evidence that the sooner you get to the operating room for an emergency surgery, the better off you are, regardless of your condition before surgery,” said senior author Dr. Alan Forster, vice-president of quality, performance and population health at the Ottawa Hospital.

Urgent surgeries are those considered necessary within 24 hours of a patient being diagnosed, in most cases at a hospital emergency department. Such surgeries represent 13 per cent of all operations performed in Ontario, according to the Ontario Ministry of Health and Long-Term Care.

“Some surgeries need to be done very promptly,” said Forster, an internist and researcher. “The hip fracture is a really good example because that’s one that really should be done within that 24-hour time frame.”

The reasons for delays were known in 39 per cent of cases. The most common causes for delay were that operating rooms were already in use or surgeons, anesthetists or surgical nursing staff were not available, he said.

Patients whose emergency surgeries are delayed due to a lack of operating room resources have an increased risk of death or a need for extra recovery time in hospital, a Canadian study suggests.