Show simple item record

dc.contributor.authorWei, N
dc.contributor.authorBaldock, TE
dc.contributor.authorElamin-Ahmed, H
dc.contributor.authorWalshaw, T
dc.contributor.authorWalker, R
dc.contributor.authorTrompeter, A
dc.contributor.authorEardley, WPG
dc.contributor.authorORTHOPOD Collaborators
dc.date.accessioned2023-12-13T16:04:55Z
dc.date.available2023-03-22
dc.date.available2023-12-13T16:04:55Z
dc.date.issued2023-06
dc.identifier.urihttps://qmro.qmul.ac.uk/xmlui/handle/123456789/92916
dc.description.abstractINTRODUCTION: ORTHOPOD: Day Case Trauma is a multicentre prospective service evaluation of day-case trauma surgery across four countries. It is an epidemiological assessment of injury burden, patient pathways, theatre capacity, time to surgery and cancellation. It is the first evaluation of day-case trauma processes and system performance at nationwide scale. METHODS: Data was prospectively recorded through a collaborative approach. Arm one captured weekly caseload burden and operating theatre capacity. Arm two detailed patient and injury demographics, and time to surgery for specific injury groups. Patients scheduled for surgery between 22/08/22 and 16/10/22 and operated on before 31/10/22, were included. For this analysis, hand and spine injuries were excluded. RESULTS: Data was obtained from 86 Data Access Groups (70 in England, 2 in Wales, 10 in Scotland and 4 in Northern Ireland). After exclusions, 709 weeks worth of data representing 23,138 operative cases were analysed. Day-case trauma patients (DCTP) accounted for 29.1% of overall trauma burden and utilised 25.7% of general trauma list capacity. They were predominantly adults aged 18 to 59 (56.7%) with upper limb Injuries (65.7%). Across the four nations, the median number of day-case trauma lists (DCTL) available per week was 0 (IQR 1). 6 of 84 (7.1%) hospitals had at least five DCTLs per week. Rates of cancellation (13.2% day-case; 11.9% inpatient) and escalation to elective operating lists (9.1% day-case; 3.4% inpatient) were higher in DCTPs. For equivalent injuries, DCTPs waited longer for surgery. Distal radius and ankle fractures had median times to surgery within national recommendations: 3 days and 6 days respectively. Outpatient route to surgery was varied. Dominant pathways (>50% patients listed at that episode) in England and Wales were uncommon but the most frequently seen was listing patients in the emergency department, 16 of 80 hospitals (20%). CONCLUSION: There is significant mismatch in DCTP management and resource availability. There is also considerable variation in DCTP route to surgery. Suitable DCTL patients are often managed as inpatients. Improving day-case trauma services reduces the burden on general trauma lists and this study demonstrates there is considerable scope for service and pathway development and improved patient experience.en_US
dc.format.extent1588 - 1594
dc.languageeng
dc.relation.ispartofInjury
dc.subjectAmbulatoryen_US
dc.subjectCancellationsen_US
dc.subjectDay-case traumaen_US
dc.subjectDelaysen_US
dc.subjectFractureen_US
dc.subjectTime to surgeryen_US
dc.subjectTraumaen_US
dc.subjectAdulten_US
dc.subjectHumansen_US
dc.subjectInpatientsen_US
dc.subjectOrthopedicsen_US
dc.subjectProspective Studiesen_US
dc.subjectUnited Kingdomen_US
dc.subjectHospitalsen_US
dc.titleORthopaedic trauma hospital outcomes - Patient operative delays (ORTHOPOD) Study: The management of day-case orthopaedic trauma in the United Kingdom.en_US
dc.typeArticleen_US
dc.identifier.doi10.1016/j.injury.2023.03.032
pubs.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/37005137en_US
pubs.issue6en_US
pubs.notesNot knownen_US
pubs.publication-statusPublisheden_US
pubs.volume54en_US
dcterms.dateAccepted2023-03-22


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record