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A retrospective analysis of factors associated with anesthetic case duration for cesarean deliveries

Harris, M.J. ; Gabriel, R.A. ; Dutton, R.P. ; Urman, R.D.

International Journal of Obstetric Anesthesia, 05/2018, Vol.34, C, pp.42-49 [Rivista Peer Reviewed]

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  • Titolo:
    A retrospective analysis of factors associated with anesthetic case duration for cesarean deliveries
  • Autore: Harris, M.J. ; Gabriel, R.A. ; Dutton, R.P. ; Urman, R.D.
  • Note di contenuto: To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1016/j.ijoa.2018.01.002 Byline: M.J. Harris (a), R.A. Gabriel (b,c), R.P. Dutton (d), R.D. Urman [rurman@bwh.harvard.edu] (a,e,*) Keywords Cesarean delivery; Anesthesia; Duration; Case; Efficiency Highlights * Cesarean delivery duration is an important component of anesthesia workload. * Case data from a national anesthesia outcomes registry were analyzed. * Variability in case duration is mostly due to institution-level factors. Abstract Introduction Accurately predicting cesarean delivery case duration is an integral component of designing appropriate workflow protocols and ensuring adequate provider availability. Our primary objective was to describe the variability of case duration, based on factors that we hypothesized would be influential, such as hospital facility type, United States region, time of day, case volume, and patient and provider characteristics. Methods We analyzed hospital-, patient-, and provider-level variables from the National Anesthesia Clinical Outcomes Registry, a voluntary registry created to share anesthesia-related data and outcomes. Multivariable linear regression was performed to assess the association of these variables to case duration. Results A total of 205 332 cases were included in the final analysis. The majority of these cases came from medium-sized community hospitals (50.8%). Mean and median case duration were 115 and 79 minutes, respectively. Mean duration was longest for cases performed at university hospitals (143 min, standard deviation 136 min). Case duration varied in clinically meaningful ways based on hospital facility type, United States region, presence of a Certified Registered Nurse Anesthetist, and anesthesia type. Differences were not clinically significant with respect to other variables studied. Conclusion This study analyzed national cesarean delivery data and determined factors associated with cesarean delivery duration. We showed that case durations varied in meaningful ways according to facility type, United States region, presence of a Certified Registered Nurse Anesthetist, and anesthesia type. Our work contributes to a small but growing body of research on optimal staffing models for anesthesia practices. Author Affiliation: (a) Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Boston, MA, United States (b) Department of Anesthesiology, University of California, San Diego, San Diego, CA, United States (c) Department of Biomedical Informatics, University of California, San Diego, San Diego, CA, United States (d) US Anesthesia Partners, Dallas, TX, United States (e) Center for Perioperative Research, Brigham and Women's Hospital, Boston, MA, United States * Correspondence to: R.D. Urman, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States. Article History: Accepted 10 January 2018
  • Fa parte di: International Journal of Obstetric Anesthesia, 05/2018, Vol.34, C, pp.42-49
  • Soggetti: Medical Care Quality – Analysis ; Registered Nurses – Analysis ; Anesthesia – Analysis ; Hospitals – Analysis ; Central Nervous System Agents – Analysis ; Cesarean Section – Analysis
  • Lingua: Inglese
  • Tipo: Articolo
  • Identificativo: ISSN: 0959289X ; DOI: http://dx.doi.org/10.1016/j.ijoa.2018.01.002

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