The “Operating Room Surgical Activity” (ORSA) study: a snap-shot international survey on the global management of the operating theatres for emergency surgery. When to persist is diabolical…

Abstract Background Despite advances and improvements in the management of surgical patients, emergency and trauma surgery is correlated with high morbidity and mortality. This is mostly due to delays in the management of patients from admission to surgical treatment in the operating room. There is a lack of studies focused on operating room prioritization and resource allocation in emergency surgery. The Operating Room Surgical Activity (ORSA) study was conceived to assess the management of operating theatres and resources from a global perspective. Method The ORSA study was conceived as an international web survey. The questionnaire was composed of 23 multiple-choice and open questions. Data were collected over 3 months. Participation in the survey was voluntary and anonymous. Results One hundred forty-seven emergency and acute care surgeons answered the questionnaire; the response rate was 7.35%. Most of the participants come from Europe. One hundred nineteen surgeons (81%; 119/147) declared to have at least 1 emergency OR in their hospital; for the others 20/147 surgeons (19%), there is not a dedicated emergency operating room. Forty-six (68/147) % of surgeons use the elective operating room to perform emergency procedures during the day, The planning of an emergency surgical procedure is made by phone (70%-104/147 of surgeons). Conclusions There is no dedicated emergency operating room in the majority of hospitals. The emergency operating room is not always available. Elective surgical procedures were postponed or cancelled to perform emergency surgery. It is a priority to validate an effective universal triaging and scheduling system to allocate emergency surgical procedures. Logistical issues have to be assessed in a multidisciplinary approach to improving patients' safety, optimal use of resources, and decreasing costs.