As I mentioned in the last post, the early literature on the use of the hybrid OR for trauma patients was just so-so. However, additional work has been done, and the real benefits are becoming clearer. Today, I’ll describe a pair of more recent, related papers that examined trauma outcomes in the hybrid OR.

The research was performed at the University of Florida Health, Gainesville. The group published an initial paper analyzing 106 adult trauma patients managed in a regular OR, comparing them with another 186 who were taken to a newly repurposed hybrid OR. This room was a remodeled angiography suite that was located within the OR complex.

Here are the factoids:

• Overall demographics of the two groups were similar
• Initial hemoglobin in the hybrid group was about 1g/dL lower (10.2 vs 11.1)
• Nine times as many hybrid patients had a REBOA balloon placed (9% vs 1%)
• The time to hemorrhage control was significantly shorter in the hybrid group
• The hybrid OR patients required fewer blood and plasma transfusions between 4 and 24 hours after arrival
• Infectious complications and ventilator days were significantly lower in the hybrid OR group
• Mortality was similar (13% hybrid vs 10% conventional)

The authors published a follow-up paper three years later in which they analyzed the original data to determine the cost-utility and value. They did this by examining the clinical outcomes relative to the cost of this new resource. They found that the costs across the patient admission were similar in the hybrid and conventional groups ($55K vs $51K).  The authors concluded that the better outcomes described in their first paper came with no significant increase in cost.

Bottom line: There is still precious little data on the benefits of the hybrid OR for trauma patients. Even though the total numbers appear to be small, it is difficult to amass the hybrid group sizes described here. It is the best US data we have so far, and shows promising results for minimal extra cost.

In my next post, I’ll conclude with some tips and tricks for setting up your own hybrid room.

References:

1. Clinical Impact of a Dedicated Trauma Hybrid Operating Room. Journal Am Col Surg 232(4):560-570, 2020.
2. Retrospective Value Assessment of a Dedicated, Trauma Hybrid Operating Room. J Trauma 94(6):814-822, 2023.