ArticleFrontiers in surgery2026
The anesthesia-to-incision interval accounts for most of the observed difference in decision-to-delivery time between urgency categories during emergency cesarean delivery: a single-center retrospective cohort study.
Article in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Decision-to-delivery interval (DDI) is widely used to audit emergency cesarean delivery, but total DDI does not distinguish workflow performance from risk-based clinical decisions. This exploratory study compared DDI between urgency categories and quantified the contribution of individual process components to the observed difference. Methods: This single-center retrospective cohort study included 80 category I or II emergency cesarean deliveries between March 1, 2024, and October 31, 2025. DDI was divided into five mutually additive intervals. Between-category mean differences and component contributions were estimated using 50,000 stratified bootstrap resamples. Anesthesia type was considered a potential process-pathway variable because urgency may influence anesthetic strategy, which may in turn affect pre-incision workflow and total DDI. Results: Median DDI was 18.0 min, and 78 cases (97.5%) achieved delivery within 30 min. Median DDI was shorter in category I than category II cases [14.0 (10.0-16.0) vs. 19.0 (17.0-23.0) minutes; Conclusion: Most emergency cesarean deliveries met the 30-minute reference threshold, and the anesthesia-to-incision interval accounted for most of the observed DDI difference between urgency categories. These exploratory findings support risk-stratified, process-based DDI audit but do not establish a causal effect of any individual interval.
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