Prone positioning in the elderly extends perioperative process times: a retrospective analysis

Area of Science:

• Orthopedic Surgery
• Geriatric Trauma
• Healthcare Management

Background:

• Cervical bone fractures are a common injury in the elderly population.
• Demographic shifts towards an aging population may increase the demand for healthcare resources.
• The prone patient position during surgery can be resource-intensive.

Purpose of the Study:

• To analyze age-related differences in pre- and intraoperative process times for cervical fracture surgery.
• To compare process times between supine and prone patient positions across different age groups.
• To inform healthcare resource planning and financial models for geriatric trauma care.

Main Methods:

• Retrospective analysis of 330 patients undergoing cervical spine surgery at a tertiary hospital.
• Patients were categorized into three age groups: ≤59 years, 60-79 years, and ≥80 years.
• Process times for anesthesia induction and surgery were recorded and compared between supine and prone positions using statistical tests.

Main Results:

• Anesthesia induction time increased with age in the supine position (4-8 minutes).
• The prone position added an average of 6 minutes to anesthesia induction in older patients.
• Prone positioning required 10-12 minutes for patient setup in older and very old patients.
• Surgical time decreased with age in the supine position but increased by 34-104 minutes in the prone position.

Conclusions:

• Prone positioning significantly extends anesthesia and surgical times in older patients with cervical fractures.
• Age-related increases in process times for prone surgery necessitate consideration in healthcare resource allocation.
• These findings are crucial for financial planning and remuneration systems, especially in the context of an aging population.