title: Outcomes variability in non-emergent esophageal foreign body removal: Is daytime removal better?
abstract: OBJECTIVE
  The objective of this study is to investigate differences between esophageal foreign body removal performed during standard operating room hours and those performed after-hours in asymptomatic patients.
  
  
  METHODS
  A retrospective chart review at a tertiary children's hospital identified 264 cases of patients with non-emergent esophageal foreign bodies between 2006 and 2011. Variables pertaining to procedure and recovery times, hospital charges, complications, length of stay, American Society of Anesthesiology (ASA) classification, and presence of mucosal injury were summarized and compared between cases performed during standard operating hours and those performed after-hours.
  
  
  RESULTS
  Cases performed during standard hours had significantly longer average wait times compared with after-hours cases (13.1h versus 9.0h, p<0.001). No other clinical characteristics or outcomes were significantly different between groups. Longer wait times are not associated with mucosal injury or postoperative complications.
  
  
  CONCLUSIONS
  There were no significant differences in procedure time, charges, or safety in after-hours removal of non-emergent esophageal foreign bodies compared to removal during standard operating hours. OR wait time was about 4h longer during standard hours compared with after-hours. This study could not assess the factors to determine the impact in differences in hospital resource utilization or work force, which may be significant between these two groups.
authors: Baylor College of Medicine, Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, United States. Electronic address: zhenh@bcm.edu.
authors: Zhen J
authors: ZJ
authors: Huang
authors: Baylor College of Medicine, Dan L. Duncan Institute for Clinical and Translational Research, United States. Electronic address: danielle.guffey@bcm.edu.
authors: Danielle
authors: D
authors: Guffey
authors: Baylor College of Medicine, Dan L. Duncan Institute for Clinical and Translational Research, United States. Electronic address: minard@bcm.edu.
authors: Charles G
authors: CG
authors: Minard
authors: Baylor College of Medicine, Texas Children's Hospital Director of the Center for Professionalism in Medicine, United States. Electronic address: ellenf@bcm.edu.
authors: Ellen M
authors: EM
authors: Friedman
mesh_terms: D002648:Child; D002675:Child, Preschool; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005547:Foreign Bodies / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D009873:Operating Rooms; D011183:Postoperative Complications; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: After-hours; Cost; Esophageal foreign body; Outcome