30 research outputs found
Comprehensive assessment of the management of acute cholecystitis in Scotland: population-wide cohort study
No full textFunding The study was funded by an NHS Grampian endowment fund (NER 11062). © The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd. Elements of this paper were presented as an oral presentation at the Surgical Research Society in Nottingham, UK on 25 March 2023. Data from this paper have also been presented in the Moynihan prize presentation section of the Association of Surgeons of Great Britain and Ireland, Harrogate, UK on 18 May 2023Peer reviewe
Trauma recidivism in England and Wales: an epidemiological study
No full textBackground: Trauma recidivism refers to patients who are injured repeatedly. There has been no evaluation of trauma recidivism in England and Wales. We hypothesize that, because population demographics and predominant trauma mechanism differ from other studied populations, the typical demographics of patients suffering repeated trauma would differ. Our aim was to determine the demographic and injury characteristics, and outcomes of patients suffering repeated trauma.
Methods: This was a national, retrospective, population-based cohort study of patients included in the prospectively collected Trauma Audit & Research Network’s (TARN) National Trauma Registry for England and Wales between 2019 and 2020. We defined recidivism as a second admission, with different injuries, within 1 year of the initial admission. Analysis was descriptive.
Results: 2517 patients (5136 admissions) were included. Median age at first admission was 81 years, and 1888 (75%) were ≥65 years. 1301 (52%) were female. The most common mechanism of injury at first and second admission was a fall ≤2 m (2159 86%, 2237 89%). 2035 (81%) suffered a fall ≤2 m on both admissions. Patients with severe injury increased from 838 (33%) to 982 (39%) from first to second admission. Patients discharged home decreased from 1776 (71%) to 1449 (58%) from first to second admission. Mortality on 2nd admission was 10.2%.
Conclusions: In England and Wales, trauma recidivism consists primarily of elderly patients who repeatedly suffer low-energy falls. It follows that prevention strategies should consist of greater and earlier involvement of multidisciplinary team input including geriatric physicians and allied health professionals, for anyone ≥65 who fulfills the criteria for TARN inclusion.
Level of evidence: Level III
Impact of deprivation and comorbidity on outcomes in emergency general surgery : an epidemiological study
No full text© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.Peer reviewe
Emergency general surgery in the United Kingdom: A lot of general, not many emergencies, and not much surgery
No full textThe impact of political crisis on smallholder pig farmers in western Kenya, 2006–2008
No full textABSTRACTFarmers and families in western Kenya have grown increasingly dependent on the pig industry as a primary resource for savings and income. The post-election crisis in 2008 had a serious impact on people living in western Kenya because the region was the stronghold of the opposition Orange Democratic Movement (ODM). The pig industry was affected in a number of ways, including an increase in the price of food and farm inputs, sale of pigs to provide food and other essentials for the family, or because of forced migration, leading to a drastic decrease in numbers of pigs. This will have a negative effect on the long-term viability of the pig industry due to decreased availability of growing, breeding and market weight animals.</jats:p
Sonorheometry versus rotational thromboelastometry in trauma: a comparison of diagnostic and prognostic performance
No full textCurrent and projected financial burden of emergency general surgery for adults in Scotland’s single payer healthcare system : a cost analysis of hospital admissions
No full textNo funding received, including none from National Institutes of Health, Wellcome Trust or Howard Hughes Medical Institute. The authors report no conflicts of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.annalsofsurgery.com).Peer reviewe
Research priorities in emergency general surgery (EGS): a modified Delphi approach
No full textBackground: Emergency general surgery (EGS) patients account for more than one-third of admissions to hospitals in the National Health Service (NHS) in England. The associated mortality of these patients has been quoted as approximately eight times higher than that of elective surgical admissions. This study used a modified Delphi approach to identify research priorities in EGS. The aim was to establish a research agenda using a formal consensus-based approach in an effort to identify questions relevant to EGS that could ultimately guide research to improve outcomes for this cohort. Methods: Three rounds were conducted using an electronic questionnaire and involved health care professionals, research personnel, patients and their relatives. In the first round, stakeholders were invited to submit clinical research questions that they felt were priorities for future research. In rounds two and three, participants were asked to score individual questions in order of priority using a 5-point Likert scale. Between rounds, an expert panel analysed results before forwarding questions to subsequent rounds. Results: Ninety-two EGS research questions were proposed in Phase 1. Following the first round of prioritisation, forty-seven questions progressed to the final phase. A final list of seventeen research questions were identified from the final round of prioritisation, categorised as condition-specific questions of high interest within general EGS, emergency colorectal surgery, non-technical and health services research. A broad range of research questions were identified including questions on peri-operative strategies, EGS outcomes in older patients, as well as non-technical and technical influences on EGS outcomes. Conclusions: Our study provides a consensus delivered framework that should determine the research agenda for future EGS projects. It may also assist setting priorities for research funding and multi-centre collaborative strategies within the academic clinical interest of EGS
