背景:多学科团队(MDT)方法可以最大程度地减少多发性创伤患者的发病率和死亡率。该项目评估了英国骨科协会目前在多大程度上满足了针对体弱骨科患者的创伤管理指南标准。
方法:在2022年3月1日至2022年3月14日的2周捕获期内,对多家医疗机构的所有创伤和骨科患者进行了回顾性分析。收集的数据包括年龄,性别,损伤,停留时间和专业输入日期。
结果:共纳入27家医院的1,050名患者。中位年龄是80岁,560(53.3%)的所有骨折是股骨颈骨折。在1,050名患者中,870例(82.9%)接受手术治疗。不同专业参与的中位数为3;645(61.4%)进行了正畸(OG)审查。在主要创伤中心(MTC),93.3%有OG输入,与非MTC的66.3%相比。输入最多的专业是放射学,塑料具有最低的输入。
结论:需要一种标准化的MDT方法来优化骨科创伤患者的护理和康复。有关专业参与的结果差异很大,需要加以解决,以最大程度地减少这一脆弱的患者队列所接受的护理差异。
BACKGROUND: A multidisciplinary team (
MDT) approach to polytrauma patients minimises morbidity and mortality. This project assesses the extent to which British Orthopaedic Association Standards for Trauma
guidelines for the management of the frail Orthopaedic patient are currently being met.
METHODS: A retrospective analysis was performed of all Trauma and Orthopaedic patients in multiple medical institutions over a 2-week capture period from 1 March 2022 until 14 March 2022 inclusive. Data collected included age, sex, injury, length of stay and dates of speciality input.
RESULTS: A total of 1,050 patients were included from 27 hospitals. The median age was 80 years, with 560 (53.3%) of all fractures being neck of femur fractures. Of the 1,050 patients, 870 (82.9%) were managed operatively. The median number of different speciality involvements was 3; 645 (61.4%) had an orthogeriatric (OG) review. In major trauma centres (MTC), 93.3% had OG input, compared with 66.3% in non-MTC. The speciality with the greatest input was Radiology, with Plastics having the lowest input.
CONCLUSIONS: A standardised
MDT approach is needed to optimise care and recovery in orthopaedic trauma patients. The difference in results regarding speciality involvement is substantial and needs to be addressed to minimise disparities in care received by this vulnerable cohort of patients.