The Fallacy of Follow-up: When Orthopaedic Trauma Patients Actually Return to Clinic

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Julie Agel ◽  
Aaron J. Robertson ◽  
Avrey A. Novak ◽  
Jonah Hebert-Davies ◽  
Conor P. Kleweno
Keyword(s):  
Trauma Patients ◽  
Orthopaedic Trauma

scholarly journals Discharge from the acute hospital: trauma patients’ perceptions of care

2016 ◽  
Vol 40 (6) ◽  
pp. 625 ◽  
Author(s):  
Lara A. Kimmel ◽  
Anne E. Holland ◽  
Melissa J. Hart ◽  
Elton R. Edwards ◽  
Richard S. Page ◽  
...  
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Trauma Patient ◽  
Patient Involvement ◽  
Acute Hospital ◽  
Trauma Patients ◽  
Orthopaedic Trauma ◽  
Lack Of Information ◽  
Follow Up Care

Objective The involvement of orthopaedic trauma patients in the decision-making regarding discharge destination from the acute hospital and their perceptions of the care following discharge are poorly understood. The aim of the present study was to investigate orthopaedic trauma patient experiences of discharge from the acute hospital and transition back into the community. Methods The present qualitative study performed in-depth interviews, between October 2012 and November 2013, with patients aged 18–64 years with lower limb trauma. Thematic analysis was used to derive important themes. Results Ninety-four patients were interviewed, including 35 discharged to in-patient rehabilitation. Key themes that emerged include variable involvement in decision-making regarding discharge, lack of information and follow-up care on discharge and varying opinions regarding in-patient rehabilitation. Readiness for discharge from in-patient rehabilitation also differed widely among patients, with patients often reporting being ready for discharge before the planned discharge date and feeling frustration at the need to stay in in-patient care. There was also a difference in patients’ perception of the factors leading to recovery, with patients discharged to rehabilitation more commonly reporting external factors, such as rehabilitation providers and physiotherapy. Conclusion The insights provided by the participants in the present study will help us improve our discharge practice, especially the need to address the concerns of inadequate information provision regarding discharge and the role of in-patient rehabilitation. What is known about the topic? There is no current literature describing trauma patient involvement in decision-making regarding discharge from the acute hospital and the perception of how this decision (and destination choice; e.g. home or in-patient rehabilitation) affects their outcome. What does this paper add? The present large qualitative study provides information on patients’ opinion of discharge from the acute hospital following trauma and how this could be improved from their perception. Patients are especially concerned with the lack of information provided to them on discharge, their lack of involvement and understanding of the choices made with regard to their discharge and describe concerns regarding their follow-up care. There is also a feeling from the patients that they are ready to leave rehabilitation before their actual planned discharge date, a concept that needs further investigation. What are the implications for practitioners? The patient insights gained by the present study will lead to a change in discharge practice, including increased involvement of the patient in the decision-making in terms of discharge from both the acute and rehabilitation hospitals and a raised awareness of the need to provide written information and follow-up telephone calls to patients following discharge. Further research into many aspects of patient discharge from the acute hospital should be considered, including the use of rehabilitation prediction tools to ensure patient involvement in decision-making and a discharge and/or follow-up coordinator to ensure patients are aware of how to access information after discharge.

scholarly journals P014: Incidental findings in trauma whole-body CT scans: a systematic review

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S69-S69
Author(s):  
V. Tsang ◽  
K. Bao ◽  
J. Taylor
Keyword(s):  
Systematic Review ◽  
Incidental Findings ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Subsequent Treatment ◽  
Whole Body ◽  
Trauma Patients ◽  
Patient Demographics ◽  
Study Results

Introduction: Whole-body computed tomography scans (WBCT) are a mainstay in the work-up of polytrauma or multiple trauma patients in the emergency department. While incredibly useful for identifying traumatic injuries, WBCTs also reveal incidental findings in patients, some of which require further diagnostic testing and subsequent treatment. Although the presence of incidental findings in WBCTs have been well documented, there has been no systematic review conducted to organize and interpret findings, determine IF prevalence, and document strategies for best management. Methods: A systematic review was conducted using MEDLINE, PUBMED, and EMBASE. Specific journals and reference lists were hand-mined, and Google Scholar was used to find any additional papers. Data synthesis was performed to gather information on patient demographics, prevalence and type of incidental findings (IFs), and follow-up management was collected. All documents were independently assessed by the two reviewers for inclusion and any disagreements were resolved by consensus. Results: 1231 study results were identified, 59 abstracts, and 12 included in final review. A mean of 53.9% of patients had at least one IF identified, 31.5% had major findings, and 68.5% had minor findings. A mean of 2.7 IFs per patient was reported for articles that included number of total IFs. The mean age of patients included in the studies were 44 years old with IFs more common in older patients and men with more IFs than women. IFs were most commonly found in the abdominal/pelvic region followed by kidneys. Frequency of follow-up documentation was poor. The most common reported mechanisms of injury for patients included in the study were MVA and road traffic accidents (60.0%) followed by falls from >3m (23.2%). Conclusion: Although there is good documentation on the mechanism of injury, patient demographics, and type of IF, follow-up for IFs following acute trauma admission lacks documentation and follow-up and is an identified issue in patient management. There is great need for systematic protocols to address management of IFs in polytrauma patients.

Which orthopaedic trauma patients need psychiatry consultation? A single institution pilot survey study

2018 ◽  
pp. 1
Author(s):  
Sean T. Campbell ◽  
Blake J. Schultz ◽  
Amanda M. Franciscus ◽  
Divy Ravindranath ◽  
Julius A. Bishop
Keyword(s):  
Survey Study ◽  
Trauma Patients ◽  
Orthopaedic Trauma ◽  
Single Institution ◽  
Pilot Survey

Do orthopaedic trauma patients develop higher rates of cardiac complications? An analysis of 56,000 patients

2016 ◽  
Vol 43 (3) ◽  
pp. 329-336 ◽  
Author(s):  
A. C. Dodd ◽  
N. Lakomkin ◽  
V. Sathiyakumar ◽  
W. T. Obremskey ◽  
M. K. Sethi
Keyword(s):  
Cardiac Complications ◽  
Trauma Patients ◽  
Orthopaedic Trauma

Presentation Coagulopathy and Persistent Acidosis Predict Complications in Orthopaedic Trauma Patients

2017 ◽  
Vol 31 (12) ◽  
pp. 617-623 ◽  
Author(s):  
Benjamin R. Childs ◽  
Daniel R. Verhotz ◽  
Timothy A. Moore ◽  
Heather A. Vallier
Keyword(s):  
Trauma Patients ◽  
Orthopaedic Trauma

Serum Vitamin D Levels in Orthopaedic Trauma Patients Living in the Northwestern United States

2013 ◽  
Vol 27 (5) ◽  
pp. e103-e106 ◽  
Author(s):  
Carson R. Bee ◽  
Daniel V. Sheerin ◽  
Thomas K. Wuest ◽  
Daniel C. Fitzpatrick
Keyword(s):  
United States ◽  
Vitamin D ◽  
Serum Vitamin ◽  
Trauma Patients ◽  
Orthopaedic Trauma ◽  
Serum Vitamin D ◽  
Vitamin D Levels
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