Canadian journal of surgery. Journal canadien de chirurgie · 2026
The growing burden of spine surgical wait times: a retrospective cohort study of longitudinal trends and impact on perioperative outcomes.
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Wang JCW, Street J, Ailon T, Bond M, Charest-Morin R, Dea N, Dvorak M, Fisher C, Kwon BK, Paquette S, Dandurand C
Аннотация
BACKGROUND: Surgical delays are common in public health care systems such as Canada's. Trends in wait times for elective spine surgery and their impact on outcomes remain uncharacterized.
METHODS: We performed a single-centre analysis of elective spine surgery data between 2009 and 2020. We assessed wait times between referral and initial consultation (T1), consultation and surgical booking (interval wait time; Ti), and booking and surgery (T2) in terms of trends and impact on perioperative outcomes (adverse events and hospital length of stay [LOS]).
RESULTS: In total, 2041 patients were included. Over the study period, total wait time (T1+Ti+T2) increased 5.6% annually (p < 0.001). Specifically, T1 decreased 4.8% (p < 0.001), Ti increased 14.9% (p < 0.001), and T2 increased 8.5% (p < 0.001) from year to year. The cumulative increase in total wait time was 72.4%, and the cumulative increase in Ti was 301.1% over the 10-year period. Longer total wait time and Ti were associated with increased rate of adverse events (p < 0.001 and p < 0.001, respectively) and odds of adverse events (p < 0.001 and p < 0.001, respectively). Delays in all wait time intervals were associated with longer LOS (p < 0.001), with T2 having the largest effect of a 10.8% increase in LOS per 100 days of T2 (p < 0.001).
CONCLUSION: Total wait times (T1+Ti+T2) for elective spine surgery significantly increased between 2009 and 2020. Ti showed the largest increase over the study period and was associated with a significant increase in adverse events. Future studies should investigate the impact of various efforts implemented and whether this translates to improved surgical outcomes and resource management.
METHODS: We performed a single-centre analysis of elective spine surgery data between 2009 and 2020. We assessed wait times between referral and initial consultation (T1), consultation and surgical booking (interval wait time; Ti), and booking and surgery (T2) in terms of trends and impact on perioperative outcomes (adverse events and hospital length of stay [LOS]).
RESULTS: In total, 2041 patients were included. Over the study period, total wait time (T1+Ti+T2) increased 5.6% annually (p < 0.001). Specifically, T1 decreased 4.8% (p < 0.001), Ti increased 14.9% (p < 0.001), and T2 increased 8.5% (p < 0.001) from year to year. The cumulative increase in total wait time was 72.4%, and the cumulative increase in Ti was 301.1% over the 10-year period. Longer total wait time and Ti were associated with increased rate of adverse events (p < 0.001 and p < 0.001, respectively) and odds of adverse events (p < 0.001 and p < 0.001, respectively). Delays in all wait time intervals were associated with longer LOS (p < 0.001), with T2 having the largest effect of a 10.8% increase in LOS per 100 days of T2 (p < 0.001).
CONCLUSION: Total wait times (T1+Ti+T2) for elective spine surgery significantly increased between 2009 and 2020. Ti showed the largest increase over the study period and was associated with a significant increase in adverse events. Future studies should investigate the impact of various efforts implemented and whether this translates to improved surgical outcomes and resource management.