Multidisciplinary Meeting

2021 ◽  
pp. 141-148
Author(s):  
Guldeniz Karadeniz Cakmak ◽  
M. Umit Ugurlu
Keyword(s):  
Multidisciplinary Meeting

scholarly journals Is There a Role for Early Palliative Intervention in Frail Older Patients With a Neck of Femur Fracture?

2018 ◽  
Vol 9 ◽  
pp. 215145931878223 ◽  
Author(s):  
Andrew Davies ◽  
Thomas Tilston ◽  
Katherine Walsh ◽  
Michael Kelly
Keyword(s):  
Palliative Care ◽  
Femur Fracture ◽  
Trauma Centre ◽  
Care Plan ◽  
X Rays ◽  
Neck Of Femur ◽  
Early Palliative Care ◽  
Multidisciplinary Meeting ◽  
Major Trauma Centre ◽  
Neck Of Femur Fracture

Background: Patients with a neck of femur fracture have a high mortality rate. National outcomes have improved significantly as the management of this patient group is prioritized. In 2016, however, 4398 (6.7%) patients died within 30 days of admission. Objective: To investigate whether palliative care could be integrated early in the care plan for high-risk patients. Methods: All cases of inpatient mortality following neck of femur fracture at North Bristol Major Trauma Centre over a 24-month period were reviewed. A comprehensive assessment of care was performed from the emergency department until death. All investigations, interventions, and management decisions were recorded. A consensus decision regarding expected mortality was made for each case at a multidisciplinary meeting which included surgical, orthogeriatric, nursing, and anesthetic team input. Results: A total of 1033 patients were admitted following a neck of femur fracture. There were 74 inpatient deaths, and 82% were considered predictable at our multidisciplinary meeting. The mean length of stay was 18 days (range: 0-85, median 14). In 42% of cases, mortality was considered predictable on admission, and 40% were considered predictable following acute deterioration. These patients received on average 28 blood tests (range: 4-114) and 6.8 X-rays and computed tomographies (range: 2-20). Of this, 66% received end-of-life care; mean duration 2.3 days (range: 0-17). Conclusions: Mortality rates remain high in a subset of patients. This study demonstrates that intensive investigation and medical management frequently continues until death, including in patients with predictably poor outcomes. Early palliative care input has been integrated successfully into patient management in other specialties. We demonstrate that it is feasible to identify patients with hip fracture who may benefit from this expertise.

scholarly journals Benefits of a virtual interstitial lung disease multidisciplinary meeting in the face of COVID ‐19

Respirology ◽  
2021 ◽  
Author(s):  
John A. Mackintosh ◽  
Laura Glenn ◽  
Hayley Barnes ◽  
Emily Dunn ◽  
Sandra Bancroft ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Multidisciplinary Meeting ◽  
The Face

The queen square encephalitis multidisciplinary meeting (infection and autoimmune): Pre and post COVID-19 experience (2018–2021)

2021 ◽  
Vol 429 ◽  
pp. 117801
Author(s):  
Rachel Brown ◽  
Tehmina Bharucha ◽  
Cristina Marcoci ◽  
Viva Levee ◽  
Sarah Weithoff ◽  
...  
Keyword(s):  
Multidisciplinary Meeting

Uptake of oncology multidisciplinary meeting recommendations

2012 ◽  
Vol 196 (1) ◽  
pp. 36-37 ◽  
Author(s):  
George H Au‐Yeung ◽  
Ahmad Aly ◽  
Andrew Bui ◽  
Carmel M Vermeltfoort ◽  
Ian D Davis
Keyword(s):  
Multidisciplinary Meeting

scholarly journals Impact of a dedicated multidisciplinary meeting on the management of superficial cancers of the digestive tract

2018 ◽  
Vol 06 (12) ◽  
pp. E1470-E1476 ◽  
Author(s):  
Solène Dermine ◽  
Maximilien Barret ◽  
Caroline Prieux ◽  
Sophie Ribière ◽  
Sarah Leblanc ◽  
...  
Keyword(s):  
Digestive Tract ◽  
Endoscopic Resection ◽  
Gastrointestinal Endoscopy ◽  
Lesion Size ◽  
Concordance Rate ◽  
Resection Rate ◽  
Tertiary Referral Center ◽  
Multidisciplinary Meeting ◽  
The Mean ◽  
The Impact

Abstract Background The recent development of endoscopic resection for superficial gastrointestinal cancers could justify the need for a dedicated oncological multidisciplinary meeting (MDM). The aim of our study was to evaluate the impact of the dedicated MDM on the management of superficial cancers of the digestive tract. Methods A dedicated MDM was developed at our tertiary referral center. A retrospective review of the MDM conclusions for all patients referred from March 2015 to March 2017 was performed. Outcomes measurements were the outcomes of endoscopic resection, and the concordance rate between the MDM recommendations, European Society of Gastrointestinal Endoscopy (ESGE) guidelines, and final patient management. Results In total, 153 patients with a median age of 69 years were included. Half of the patients had major comorbidities. The mean lesion size was 25 mm, and R0 and curative resection rate were 73.9 % and 56.9 %, respectively. Forty-three patients had an indication for surgery after endoscopic resection. The concordance rate between ESGE guidelines and MDM recommendation was 92.2 %, and 12 patients did not receive the treatment recommended due to comorbidities. Conclusion A MDM dedicated to superficial tumors helped tailor the ESGE guidelines to each patient in order to avoid unnecessary surgery.

scholarly journals How Can a Multidisciplinary Approach Improve Prognosis of Soft-Tissue Sarcomas of Extremities?

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Asmae Mazti ◽  
Mohamed El Idrissi ◽  
Abdelhalim El Ibrahimi ◽  
Mustapha El Maaroufi ◽  
Ghizlane El Koubaiti ◽  
...  
Keyword(s):  
Survival Rate ◽  
Soft Tissue ◽  
Malignant Tumors ◽  
Research Work ◽  
Soft Tissue Sarcomas ◽  
University Hospital ◽  
R0 Resection ◽  
Magnetic Resonance Imaging Scan ◽  
Tumor Type ◽  
Multidisciplinary Meeting

Soft-tissue sarcomas are malignant tumors that require good management within specialized centers. Our study aims to assess the benefit of handling these kinds of tumors using the Multidisciplinary Meeting (MDM) approach. The current paper details this approach through a prospective study that has lasted for 42 months in the HASSAN II University Hospital Center, Fez, Morocco. During this research work, 116 cases were selected with an average age of 53 years. In 95.7% of the cases, it was found that the lower limb was the most frequent tumor type (78.4%). Also, ninety-two (92) patients (79.3%) have had a prior biopsy. Ninety-nine (99) patients (85.3%) have received a magnetic resonance imaging scan (MRI) before surgery. Sixty-three (63) patients were operated on, including R0 resection used for 37 patients, R1 used for 21 patients, and R2 used for five patients. As a result, liposarcomas were the most frequent type (30.1%), followed by synovial sarcomas (14.6%), leiomyosarcomas (9.5%), ewing sarcoma (8.6), and undifferentiated pleomorphic sarcomas (7.7%). In addition, neoadjuvant chemotherapy was used for 36 patients. The other 22 patients received adjuvant chemotherapy and/or radiotherapy. The overall survival rate was 60.56 months, which proves a significant improvement, thanks to the multidisciplinary meeting approach. Conclusion. The conducted investigation has shown that using MDM for managing soft-tissue sarcomas of extremities improves the patients’ survival rate. Moreover, results have proven MDM might allow optimal treatment regarding less local recurrence and metastasis.

scholarly journals Clinical and radiological features that predict malignant transformation in cystic lesions of the pancreas: a retrospective case note review

2019 ◽  
Vol 1 ◽  
pp. 4
Author(s):  
Margaret G. Keane ◽  
Hannah R. Dadds ◽  
Ghassan El Sayed ◽  
Tu Vinh Luong ◽  
Brian R. Davidson ◽  
...  
Keyword(s):  
High Risk ◽  
Malignant Transformation ◽  
Cystic Lesions ◽  
Retrospective Case ◽  
Radiological Features ◽  
Multidisciplinary Meeting ◽  
Mucinous Neoplasms ◽  
Low Incidence ◽  
Immediate Surgery

Background: Pancreatic cystic lesions (PCL) are being detected with increasing frequency. Current methods of stratifying risk of malignant transformation are imperfect. This study aimed to determine the frequency of pancreatic malignancy in patients with PCL and define clinical and radiological features that predict malignant transformation in patients managed by surgery and/or surveillance. Methods: A retrospective cohort of adults who were evaluated in a tertiary hepatopancreaticobiliary centre between January 2000 - December 2013 with a confirmed PCL and followed up for at least 5 years. All cystic lesions were discussed at a weekly multidisciplinary meeting. Results: Of the 1,090 patients diagnosed with a PCL, 768 patients were included in the study: 141 patients were referred for immediate pancreatic resection, 570 entered surveillance while 57 had a malignant PCL which was unresectable at diagnosis (n=47) or were unfit for surgery (n=10). In those who were resected following presentation, malignancy was present in 38%. During follow-up 2% of those entering a surveillance programme underwent malignant transformation. Clinical and radiological features associated with a high-risk PCL included older age, symptoms, associated solid component or dilated main pancreatic duct. In intraductal papillary mucinous neoplasms, larger size was not a feature of malignant transformation (benign vs. malignant 30mm vs. 23mm; P= 0.012). Conclusion: The sensitivity of standard diagnostic tests leading to immediate surgery for high-risk PCL (malignant or mucinous) was 92% but with a specificity of just 5%. Surveillance of PCL without high-risk features within a multidisciplinary meeting was associated with a low incidence of cancer development, supporting the use of worrisome clinical and radiological features in the initial stratification of PCL.

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