Patterns and Outcomes of Neurosurgery in England Over a Five-year Period: a National Retrospective Cohort Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 371,418
- 主要终点
- Length of stay
研究概览
简要总结
Neurosurgical practice has seen many important changes over several decades with advances in treatments and the types of patients treated. Neurosurgical procedures have evolved, and as outcomes have improved the number of patients being treated has increased.
There are no recent evaluations of national neurosurgical practice in the United Kingdom (UK), with the last prospective cohort studies being Safe Neurosurgery 1993 and Safe Neurosurgery 2000. More recent studies of neurosurgical services have been based on data from single institutions or surgeons and these may not give a representative picture of practice nationally.
Recent national quality improvement programmes for neurosurgery in England (such as the National Neurosurgical Audit Programme (NNAP) and Cranial Neurosurgery and Spinal Surgery Getting It Right First Time (GIRFT) Programmes) have focused on using national hospital administrative datasets. To be effective, quality improvement initiatives require robust outcome measures and quality (process) indicators. Currently, there is a lack of validated quality indicators for neurosurgery, with practice often being described using generic measures such as readmission and reoperation rates and length of stay. Many studies have been able to derive these common outcome measures, but it may also be possible to produce indicators specific to neurosurgery.
The aim of this observational study was firstly to describe the current pattern of neurosurgical admissions and procedures in England, and thereby given an overview of the epidemiology of neurosurgical patients. Secondly, it aims to investigate the range of outcome measures that might be produced from hospital administrative data and use these to assess the quality of care in neurosurgery.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •All admissions to neurosurgical units in the National Health Service (NHS) in England.
排除标准
- •Records with poor quality data (e.g. no data for clinical diagnoses).
- •Patients under 18 years that were admitted to an adult neurosurgical unit.
结局指标
主要结局
Length of stay
时间窗: From date of admission to date of discharge from hospital; assessed up to 60 months.
Length of the hospital admission to neurosurgery
Proportion of patients discharged home
时间窗: Determined on date of discharge from hospital; assessed up to 60 months.
Proportion of patients discharged to their normal address.
In-patient mortality rate
时间窗: From date of the neurosurgical procedure through date of death from any cause (in-patient deaths only); assessed up to 60 months.
In-patient mortality after a neurosurgical procedure.
Additional inpatient neurosurgical procedure rate
时间窗: From date of admission to date of discharge from hospital; assessed up to 60 months.
A further neurosurgical procedure in admissions where patients have had a primary (main) neurosurgical procedure.
次要结局
未报告次要终点
研究者
Ryan Mathew
Associate Professor and Consultant Neurosurgeon
University of Leeds