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How Well Planned Urgency Class Come True in The Emergency Surgery? Timing of Acute Care Surgery.

https://arctichealth.org/en/permalink/ahliterature309633
Source
Scand J Surg. 2020 Jun; 109(2):85-88
Publication Type
Journal Article
Date
Jun-2020
Author
V Koivukangas
A Saarela
S Meriläinen
H Wiik
Author Affiliation
Department of Surgery, Oulu University Hospital and University of Oulu, Oulu, Finland.
Source
Scand J Surg. 2020 Jun; 109(2):85-88
Date
Jun-2020
Language
English
Publication Type
Journal Article
Abstract
Emergency surgery represents an essential aspect of surgical care, but little is known about realization of the planned emergency class. Different systems such as NCEPOD classification and Timing of Acute Care Surgery classification have been developed for the timing of the emergency surgery. The aim of the study was to find out how well planned urgency class is being implemented.
The planned and realized waiting times for all emergency surgeries were studied during the 6-month period in the Oulu University Hospital. The catchment area of the hospital includes a population of 742,000. The urgency in the hospital is planned in a four-step scale: an extremely urgent (E) patient should be taken immediately to the operating theater. Class I urgency surgery should start within 3?h (180?min), class II within 8 h (480?min), and class III within 24?h (1440?min). Surgeon plans urgency at his discretion, and no specific urgency has been imposed on certain diagnoses thus the surgeon's perceptions of the illness or trauma affects the assessment.
Extreme urgent patients had an average waiting time of 26?min. For class I patient, the average waiting time was 59?min, while 93% of surgeries were started within the target time. For class II and class III patients, these figures were 337?min and 86% and 830?min and 78%, respectively.
With regard to urgency, the higher the degree of urgency, the greater the chance of the surgery being realized within the planned time.
PubMed ID
30786828 View in PubMed
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How Well Planned Urgency Class Come True in The Emergency Surgery? Timing of Acute Care Surgery.

https://arctichealth.org/en/permalink/ahliterature311833
Source
Scand J Surg. 2020 Jun; 109(2):85-88
Publication Type
Journal Article
Date
Jun-2020
Author
V Koivukangas
A Saarela
S Meriläinen
H Wiik
Author Affiliation
Department of Surgery, Oulu University Hospital and University of Oulu, Oulu, Finland.
Source
Scand J Surg. 2020 Jun; 109(2):85-88
Date
Jun-2020
Language
English
Publication Type
Journal Article
Keywords
Acute Disease - epidemiology - therapy
Emergencies - classification - epidemiology
Finland - epidemiology
General Surgery - organization & administration - statistics & numerical data
Humans
Internship and Residency - organization & administration - statistics & numerical data
Operating Rooms - organization & administration - statistics & numerical data
Surgical Procedures, Operative - classification - statistics & numerical data
Time Factors
Triage - classification - statistics & numerical data
Abstract
Emergency surgery represents an essential aspect of surgical care, but little is known about realization of the planned emergency class. Different systems such as NCEPOD classification and Timing of Acute Care Surgery classification have been developed for the timing of the emergency surgery. The aim of the study was to find out how well planned urgency class is being implemented.
The planned and realized waiting times for all emergency surgeries were studied during the 6-month period in the Oulu University Hospital. The catchment area of the hospital includes a population of 742,000. The urgency in the hospital is planned in a four-step scale: an extremely urgent (E) patient should be taken immediately to the operating theater. Class I urgency surgery should start within 3?h (180?min), class II within 8 h (480?min), and class III within 24?h (1440?min). Surgeon plans urgency at his discretion, and no specific urgency has been imposed on certain diagnoses thus the surgeon's perceptions of the illness or trauma affects the assessment.
Extreme urgent patients had an average waiting time of 26?min. For class I patient, the average waiting time was 59?min, while 93% of surgeries were started within the target time. For class II and class III patients, these figures were 337?min and 86% and 830?min and 78%, respectively.
With regard to urgency, the higher the degree of urgency, the greater the chance of the surgery being realized within the planned time.
PubMed ID
30786828 View in PubMed
Less detail

How Well Planned Urgency Class Come True in The Emergency Surgery? Timing of Acute Care Surgery.

https://arctichealth.org/en/permalink/ahliterature298319
Source
Scand J Surg. 2019 Feb 20; :1457496919826716
Publication Type
Journal Article
Date
Feb-20-2019
Author
V Koivukangas
A Saarela
S Meriläinen
H Wiik
Author Affiliation
Department of Surgery, Oulu University Hospital and University of Oulu, Oulu, Finland.
Source
Scand J Surg. 2019 Feb 20; :1457496919826716
Date
Feb-20-2019
Language
English
Publication Type
Journal Article
Abstract
Emergency surgery represents an essential aspect of surgical care, but little is known about realization of the planned emergency class. Different systems such as NCEPOD classification and Timing of Acute Care Surgery classification have been developed for the timing of the emergency surgery. The aim of the study was to find out how well planned urgency class is being implemented.
The planned and realized waiting times for all emergency surgeries were studied during the 6-month period in the Oulu University Hospital. The catchment area of the hospital includes a population of 742,000. The urgency in the hospital is planned in a four-step scale: an extremely urgent (E) patient should be taken immediately to the operating theater. Class I urgency surgery should start within 3?h (180?min), class II within 8 h (480?min), and class III within 24?h (1440?min). Surgeon plans urgency at his discretion, and no specific urgency has been imposed on certain diagnoses thus the surgeon's perceptions of the illness or trauma affects the assessment.
Extreme urgent patients had an average waiting time of 26?min. For class I patient, the average waiting time was 59?min, while 93% of surgeries were started within the target time. For class II and class III patients, these figures were 337?min and 86% and 830?min and 78%, respectively.
With regard to urgency, the higher the degree of urgency, the greater the chance of the surgery being realized within the planned time.
PubMed ID
30786828 View in PubMed
Less detail

The quality of life of gastroesophageal reflux disease patients waiting for an antireflux operation.

https://arctichealth.org/en/permalink/ahliterature15069
Source
Surg Endosc. 2004 Dec;18(12):1712-5
Publication Type
Article
Date
Dec-2004
Author
T. Heikkinen
V. Koivukangas
H. Wiik
J. Saarnio
T. Rautio
K. Haukipuro
Author Affiliation
Department of Surgery, Oulu University Hospital, 90021, PL 21, Oulu, OYS, Finland. timo-jaakko.heikkinen@oulu.fi
Source
Surg Endosc. 2004 Dec;18(12):1712-5
Date
Dec-2004
Language
English
Publication Type
Article
Abstract
BACKGROUND: The purpose of this trial was to measure the health-related quality of life (HRQL) of gastroesophageal reflux disease (GERD) patients waiting for an antireflux operation. METHODS: A total of 120 patients waiting for a laparoscopic fundoplication were sent questionnaires measuring their symptoms and quality of life. RESULTS: Ninety-five of the patients still needing an operation returned the questionaires and were included in the analysis. Thirty-one of 84 patients (37%) felt that the symptoms had worsened, and 51/90 (57%) were unsatisfied. Thirty percent suffered from throat or airway infections, 25% from swallowing difficulties, 48% from retrosternal pain, and 18% had asthma. The mean GERD HRQL score (0-45) was 21.7 (95% confidence interval, 19.7-23.7). Short Form-36 scores of this population were significantly worse when compared to patients with inguinal hernia or moderate asthma. CONCLUSIONS: Patients waiting for a fundoplication seem to have a significantly decreased health-related quality of life due to poor symptom control regardless of continuous medical treatment.
PubMed ID
15809777 View in PubMed
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Survival after surgery for gastric cancer in patients over 70 years of age.

https://arctichealth.org/en/permalink/ahliterature20001
Source
Ann Chir Gynaecol. 2000;89(4):268-72
Publication Type
Article
Date
2000
Author
J T Mäkelä
H. Kiviniemi
H. Wiik
S. Laitinen
Author Affiliation
Oulu University Hospital, Department of Surgery, Finland. Jyrki.Makela@oulu.fi
Source
Ann Chir Gynaecol. 2000;89(4):268-72
Date
2000
Language
English
Publication Type
Article
Keywords
Aged
Female
Finland - epidemiology
Gastrectomy
Humans
Male
Morbidity
Multivariate Analysis
Proportional Hazards Models
Retrospective Studies
Risk factors
Stomach Neoplasms - mortality - surgery
Survival Analysis
Abstract
BACKGROUND AND AIMS: The increase of the elderly population in western societies will result in a considerable increase of gastric cancer patients older than 70 years requiring surgery. However, higher postoperative morbidity and mortality rates after major surgery in the elderly are well recognized. The aim of this study was to evaluate the risk factors of mortality and predictors of survival in elderly patients with gastric cancer. METHODOLOGY: We reviewed the data of the 165 patients evaluated for gastric cancer surgery in the Oulu University Hospital from January 1985 till December 1994 and made a computer analysis. RESULTS: Postoperative mortality was 12% both after all laparotomies and after all resections, and 6% after radical resections. Mortality after radical resection did not associate significantly with any clinical variable but morbidity was associated with the number of coexistent diseases. The median and cumulative 5-year survivals after radical resections were 40 months and 38%. Survival was closely related to diagnostic delay, preoperative loss of weight, two or more coexistent disease, location of tumor, and recurrence in univariate analysis, but multivariate analysis showed only preoperative weight loss and recurrent disease to be independent predictors of survival. CONCLUSIONS: Age alone is not a risk factor for postoperative mortality or a predictor of survival among elderly patients with gastric cancer. Early detection of malignancy and careful preoperative evaluation of the patients referred for resection are needed to improve survival.
PubMed ID
11204956 View in PubMed
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