Intervention rates are low after direct discharge from the Edinburgh trauma triage clinic: Outcomes of 6,688 patients |
| |
| Affiliation: | 1. Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, 51 Little France, Edinburgh, EH16 4SA, UK;2. Usher Institute, University of Edinburgh, 9 Little France Rd, Edinburgh EH16 4UX, UK;1. St Thomas’ Hospital, London, UK;2. East & North Hertfordshire NHS Trust, Stevenage SG1 4AB, Hertfordshire;3. St George''s, University of London, London SW17 0RE, UK;4. Imperial College London, London SW7 2BX, UK;1. Department of Pediatrics, Johns Hopkins University School of Medicine; 733 N Broadway, Baltimore, MD 21205, United States;2. Division of Pediatric Emergency Medicine, Johns Hopkins University School of Medicine; 733 N Broadway, Baltimore, MD 21205, United States;3. General Pediatric Surgery, Johns Hopkins University School of Medicine; 733 N Broadway, Baltimore, MD 21205, United States;1. King''s Centre for Global Health and Health Partnerships, Faculty of Life Sciences and Medicine, King''s College London, UK;2. University of Exeter Medical School, University of Exeter, UK;3. Department of Orthopaedics, Ndola Teaching Hospital, Zambia;4. Medway NHS Foundation Trust, Kent, UK;5. Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK;1. Department of Orthopedic Surgery, the Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang 050051 China;2. Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, No.361 Zhongshan Road, Shijiazhuang 050017 China;1. Department of neurosurgery Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran;2. Department of pediatrics, Shahid Beheshti University of Medical Sciences, Tehran, Iran;3. Department of neurosurgery, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran;4. Department of neurosurgery, Shahid Beheshti University of Medical Sciences, Loghman Hakim hospital;5. Department of anesthesiology, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah,Iran;6. Clinical Research Development Center, Imam Reza hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran;7. Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran;8. Wayne State University School of Medicine, Detroit, MI, USA |
| |
| Abstract: | AimThe Edinburgh Trauma Triage clinic (TTC) is an established form of Virtual Fracture clinic (VFC) that permits the direct discharge of simple, isolated fractures from the Emergency Department (ED). Small, short-term cohort studies of similar systems have been published, but to detect low rates of complications requires a large study sample and longer-term follow-up. This study details the outcomes of all patients with injuries suitable for a direct discharge protocol over a four-year period, reviewed at a minimum of three years after attendance.PatientsAll TTC records between February 2014 and December 2017 were collated from a prospective database. Fractures of the radial head, little finger metacarpal, fifth metatarsal, toe phalanges and mallet finger injuries were included. TTC outcome, including any deviations from a well-established direct discharge protocol, were noted. All records were re-assessed at a minimum of 36 months after TTC triage (mean 54 months) to ascertain which injuries attended the trauma clinic after initial discharge. Reasons for attendance, the source of referral and any subsequent surgical procedures were identified.ResultsThere were 6688 patients with fractures of the radial head (1861), little finger metacarpal (1621), fifth metatarsal (1916), toe phalanges (920) and mallet finger injuries (370). 298 (6%) patients were re-referred after direct discharge and attended trauma clinic at a mean time after injury of 11.9 weeks, of whom 11 (0.2%) underwent a surgical intervention. Serious adverse events, defined as those in which a patient may not have come to harm if early clinical review had been undertaken, occurred in 1 patient (0.01%).ConclusionIntervention after direct discharge of simple pre-defined injuries of the elbow, hand and foot is low. Within a TTC system, patients with these injuries can be safely discharged without routine follow-up. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
