• David Carver, Andrew W Kirkpatrick, Scott D'Amours, S Morad Hameed, Julie Beveridge, and Chad G Ball.
• Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
• Ann. Surg. 2020 May 1; 271 (5): 958-961.

ObjectiveThe primary objective of this study was to evaluate the utility, clinical impact, and work flow of a new trauma hybrid operating theater.Summary Background DataThe potential utility and clinical benefit of hybrid operating theaters are increasingly postulated. Unfortunately, the clinical outcomes and efficiencies of these environments remain unclear.MethodsAll severely injured patients who were transferred to the hybrid suite for emergent intervention between 2013 and 2017 were compared to consecutive prehybrid patients. Standard statistical methodology was employed (P < 0.05 = significant).ResultsOne hundred sixty-nine patients with severe injuries (mean ISS = 23; hemodynamic instability = 70%; hospital/ICU stay = 12 d; mortality = 14%) were transferred urgently to the hybrid suite. Most were young (38 yrs) males (84%) with blunt injuries (51%). Combined hybrid trauma procedures occurred in 18% of cases (surgery (82%) and angiography (11%) alone). Procedures within the hybrid suite included: laparotomy (57%), extremity (14%), thoracotomy/sternotomy (12%), angioembolization of the spleen/pelvis/liver/other (9%), neck (9%), craniotomy (4%), and aortic endostenting (6%). Compared with historical controls, use of the hybrid suite resulted in shorter arrival to intervention and total procedure times (P < 0.05). A clear benefit for survival was evident (42% vs. 22%).ConclusionsAvailability of a hybrid environment for severely injured patients reduces time to intervention, total procedural duration, blood product transfusion and salvages a small subset of patients who would not otherwise survive. The cost associated with a hybrid suite remains prohibitive for many centers.

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