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Vascular Surgeons are an Essential Operating Room Resource
Rachel Danczyk, MD, Jordan Allensworth, Jake Coleman, Vincent Santo, MD, Gregory Landry, MD, Timothy Liem, MD, Erica Mitchell, MD, Amir Azarbal, MD, Gregory Moneta, MD.
Oregon Health and Science University, Portland, OR, USA.
OBJECTIVES: Vascular surgeons may aid in primarily nonvascular procedures. Such activity has not been quantified and hospital administrators may be unaware of the importance of vascular surgeons to support other hospital based surgical programs. This study reviews intraoperative consultations by vascular surgeons to support other surgical services.
METHODS: Intraoperative vascular consultations were reviewed from 01/06 to 08/12 for consulting service, indication, and whether consultation occurred with advanced notice. Patient demographics, operative times, estimated blood loss (EBL) and length of stay for patients receiving intraoperative vascular consultation were also assessed. Consultations for trauma and iatrogenic injuries occurring outside the operating theater were excluded.
RESULTS: 196 intraoperative consultations were performed in support of procedures by nonvascular surgeons (81% emergent without prior notice). Requesting services were surgical oncology (42%), orthopedics (19%), urology (11%), other (28%). Reasons for consultation overlapped and included emergent vascular reconstruction (43%), control of hemorrhage (36%) and assistance with difficult dissections (36%). 89% were for intraabdominal procedures with venous (55%) and arterial (45%) problems relatively equally distributed. Most patients were male (61%), overweight (56% BMI >25), had had previous surgery (71%) and were undergoing elective procedures (65%). Mean anesthesia time was 8.9 hours and mean total and vascular related EBL 1655 and 328ccs respectively. Mean length of stay was 15.2 days and 30-day mortality was 4%.
CONCLUSIONS: When considering distribution of resources, hospital administrators should be aware vascular surgeons provide urgent and essential expertise to performance of difficult procedures by hospital based high profile surgical programs.
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