Annals of the Royal College of Surgeons of England
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Ann R Coll Surg Engl · May 2019
Multicenter Study Comparative StudyMortality for emergency laparotomy is not affected by the weekend effect: a multicentre study.
The 'weekend effect' describes variation in outcomes of patients treated over the weekend compared with those treated during weekdays. This study examines whether a weekend effect exists for patients who undergo emergency laparotomy. ⋯ Quality of care and clinical outcomes for patients undergoing emergency laparotomy during the weekend are not significantly different to those carried out during weekdays.
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Ann R Coll Surg Engl · Nov 2015
Multicenter StudyLitigation costs of wrong-site surgery and other non-technical errors in orthopaedic operating theatres.
This study reviews the litigation costs of avoidable errors in orthopaedic operating theatres (OOTs) in England and Wales from 1995 to 2010 using the National Health Service Litigation Authority Database. ⋯ Improved patient-safety strategies such as the World Health Organization Surgical Checklist may be responsible for the recent reduction in prevalence of litigation for NTEs. However, addition of a specific feature in orthopaedic surgery, an 'implant time-out' could translate into a cost benefit for National Health Service hospital trusts and improve patient safety.
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Ann R Coll Surg Engl · Apr 2015
Multicenter StudyRenal injury management in an urban trauma centre and implications for urological training.
The aim of this study was to analyse the treatment and management of renal injury patients presenting to our major trauma unit to determine the likelihood of patients needing immediate nephrectomy. ⋯ Trauma patients rarely require emergency nephrectomy. Radiological selective embolisation provides a good interventional option in cases of active bleeding from renal injury in haemodynamically stable patients. This has implications for trauma care and how surgical cover is provided for the rare event of nephrectomy.
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Ann R Coll Surg Engl · May 2014
Multicenter Study Comparative StudyThe yield of colorectal cancer among fast track patients with normocytic and microcytic anaemia.
We receive fast track referrals on the basis of iron deficiency anaemia (IDA) for patients with normocytic anaemia or for patients with no iron studies. This study examined the yield of colorectal cancer (CRC) among fast track patients to ascertain whether awaiting confirmation of IDA is necessary prior to performing bowel investigations. ⋯ There is no significant difference in the yield of CRC between fast track patients with microcytic and normocytic anaemia. This study provides insufficient evidence to support awaiting confirmation of IDA in fast track patients with normocytic anaemia prior to requesting bowel investigations.
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Ann R Coll Surg Engl · Apr 2010
Multicenter StudyEvaluation of the introduction of a standardised protocol for the staging and follow-up of colorectal cancer on resection rates for liver metastases.
In 2004, an audit in our unit demonstrated wide variation in liver resection rates for colorectal cancer (CRC) metastases within the cancer network. Subsequently, a network-wide CT-based follow-up and referral policy was introduced for all patients. A second audit was performed to assess the impact of the guidelines on liver resection rates. ⋯ Introduction of a referral protocol standardised resection rates from the four district hospitals, but these remain lower compared to the specialist centre. The wide-spread adoption of a policy to discuss all patients with liver metastases at an advanced disease multidisciplinary team meeting, in the presence of hepatobiliary specialists, may further increase resection rates across the UK.