Geographic Influences on Appendicectomy Outcomes
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 40,000
- 试验地点
- 1
- 主要终点
- Post-operative length of stay
研究概览
简要总结
Introduction
Appendicitis is a common condition which represents a significant resource burden for the Scottish National Health Service (NHS). It is unknown whether there are significant differences in outcomes following appendicectomy which may be explained by geographic factors.
Aims
The aim of this study is to describe appendicectomy outcomes in Scotland as they vary by the urban-rural nature of the patient's home location and travel time from hospital.
Methods
This research study is a retrospective observational enquiry which will utilise administrative data from the Information Services Division (ISD) of NHS National Services Scotland. Patient episodes will be identified by a procedure code for appendicectomy, and the urban-rural classification of patients will be derived from postcode data. Travel time from hospital will also be estimated through postcode data. The investigators will study a 10 year period from January 2001 to December 2010.
Primary outcome measures will be risk-adjusted 30 day/inpatient mortality, 30 day readmission rate, 30 day re-operation rate, length of stay and negative appendicectomy rates.
详细描述
The aim of this study is to explore the possibility that outcome from appendicectomy may vary according to:
- the urban-rural nature of the patient's home location and
- travel time from hospital.
This is a retrospective study of all appendicectomies performed in Scotland during the period from 1st January 2001 - 31st December 2010. It will use routinely collected administrative data from the Information Services Division (ISD) of NHS National Services Scotland.
Potentially significant confounding variables such as age, gender, and co-morbidity will be studied for their predictive value in a univariate model and included in a multivariate model if they remain significant.
There is no single appendicectomy outcome measure which is a literature standard, so all of the following will be evaluated as primary outcome measures: risk-adjusted 30 day/inpatient mortality, 30 day readmission rate, 30 day re-operation rate, length of stay and negative appendicectomy rates.
研究设计
- 研究类型
- Observational
- 观察模型
- Ecologic Or Community
- 时间视角
- Retrospective
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •All patients, of all ages, undergoing appendicectomy (OPCS code H01) during the time period January 2001 - December 2010.
排除标准
- •Patients undergoing appendicectomy for whom this is incidental to a more major abdominal procedure.
- •Patients non-resident in Scotland.
结局指标
主要结局
Post-operative length of stay
时间窗: From date of appendicectomy to date of discharge (whole days) - see below
(Whole) days from date of laparotomy to date of discharge. Because this is a retrospective study using a complete national data set, with the last admission 2.5 years distant from the time of data collection, we will use actual time period rather than censoring length of stay at a set point.
Re-operation
时间窗: Within the index admission or within 30 days of discharge
The occurrence of an abdominal procedure either subsequent to appendicectomy and within the index admission, or ≤30 days of discharge.
Re-admission
时间窗: Within 30 days of index discharge
Re-admission to any hospital specialty ≤30 days have elapsed since date of discharge.
Mortality
时间窗: Either within 30 days of procedure, or during continuous in-patient stay
Death as an in-patient or ≤30 days of procedure. Deaths will be recognised from SMR01 which is linked to the Registrar General's database of deaths.
Negative Appendicectomy Rate
时间窗: At time of index procedure
The rate of appendicectomies performed in which the appendix is found to be normal. This will be detected by the use of ICD-10 codes.
次要结局
未报告次要终点