scholarly journals EP.TH.640Outcomes in Elective and Emergency Laparoscopic Cholecystectomies in a District General Hospital

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ahmed Nur ◽  
Aditya Agrawal
Keyword(s):  
General Hospital ◽  
Bile Leak ◽  
District General Hospital ◽  
Perioperative Outcomes ◽  
Electronic Patient Records ◽  
Incision And Drainage ◽  
Retrospective Audit ◽  
Operative Findings ◽  
Time Of Operation ◽  
Base Data

Abstract Aims To evaluate early perioperative outcomes following emergency and elective laparoscopic cholecystectomies in a district general hospital against the national average. Methods A retrospective audit was carried out on consecutive Laparoscopic Cholecystectomies performed between January 2020 and June 2018. All indications were included. Demographics and base data included; age, gender, ASA grade, type of surgery (Emergency/Elective), number of symptomatic days preoperatively, preoperative bloods, preoperative ERCP, operative findings, postoperative complications and length of stay. Data was gathered from physical and electronic patient records. Results 166 laparoscopic cholecystectomies were included in the audit. Of the 166 included patients, 48 were male and 118 were female. Mean age at time of operation was 53.4 years. 106 of the laparoscopic cholecystectomies were carried out as Elective cases and 60 were performed as Emergencies. 100% of cases were performed laparoscopically, with 3 cases requiring conversion to open intraoperatively. Postoperatively, 5 patients had post-op pneumonia. There were 3 documented cases of bile leak with 1 patient requiring ERCP as a result. There were 2 cases of wound infection requiring re-admission. Other documented complications included; umbilical port sit abscess requiring incision and drainage, collection in the gallbladder fossa, small bowel injury and a post-op drop in Haemoglobin requiring transfusion. Conclusions Outcomes in this cohort of patients undergoing laparoscopic cholecystectomies are comparable to national data. The focus of further evaluation from this cohort should be to compare outcomes between Emergency and Elective Laparoscopic Cholecystectomies, with Emergency cases further stratified according to the number of symptomatic days preoperatively.

Management of diabetic ketoacidosis in a district general hospital: a 3 years retrospective audit

2013 ◽  
pp. 1-1
Author(s):  
Mohamed Ahmed ◽  
Juaidy Zakaria ◽  
Caitriona Doyle ◽  
Ciana McCarthy ◽  
Cathrine McHugh
Keyword(s):  
Diabetic Ketoacidosis ◽  
General Hospital ◽  
District General Hospital ◽  
Retrospective Audit

scholarly journals N05 IBDoc® Faecal calprotectin self-test retrospective audit in a District General Hospital (DGH)

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S659-S660
Author(s):  
P Avery ◽  
K Blackmore ◽  
C Angel
Keyword(s):  
Smart Phone ◽  
District General Hospital ◽  
Disease Assessment ◽  
Electronic Patient Records ◽  
Faecal Calprotectin ◽  
Retrospective Audit ◽  
Continued Use ◽  
Self Test ◽  
Comparative Results ◽  
Endoscopic Investigation

Abstract Background In 2016, a DGH in England commenced the IBDoc® Faecal calprotectin test. Using smart phone technology, the test can provide results as quickly as 2 hrs. An audit of patients who trialled the test was presented at ECCO in 2017; this abstract looked at the value of the tests and helped to show the investigations worth to the DGH trust. The continued use of the test at the trust has recently been audited and these data are presented by the authors to help further understand the benefit. Methods A retrospective audit of patients enrolled on the IBDoc® between July 2017 and October 2019 was carried out by the IBD nursing team. Electronic patient records were searched and corresponding endoscopic assessments that had been carried out within 6 months of the most recent IBDoc® results, were documented for each patient. The terms normal/mild, moderate and severe were used to categorise inflammation seen at colonoscopy, flexible-sigmoidoscopy (C/FS) and/or histopathology (HP). The IBDoc® uses the categories normal (<150) moderate (<400), and high (>400); these values have been set locally easy comparison of these data is possible due to the three levels of stratification. The reason for the endoscopic investigation was also documented. In the sample where no endoscopic investigation was recorded, outcomes were categorised into three groups; well (W), increase monitoring (IM), and treatment adjustment required (TAR). Results 134 patients are signed up to the IBDoc®, 23 patients failed to carry out the test successfully (CD 14 and UC 9). 6 did not accept a test in clinic due to changing their mind or failure in smart phone technology, 12 did not do the test before expiry* and 5 failed to give a result due to difficulties completing the test. *Myriad of reasons were given for not doing the test and another paper could be written to attempt to understand the persons motivation for not completing the test. Of the 111 patients’ (CD 55, UC 56, IBDU 2 and non-IBD 2), 80 patients did not undergo a C/FS, of the 31 that did, correlation between calprotectin, C/FS and/or HP result was 84%. at 100% best correlation was seen in the severe C/FS results and high IBDoc® results. C/FS were carried out for diagnosis (n =10) surveillance (n =4) and disease assessment (n = 17). In the 80 patients with no colonoscopy’s were assessed for outcomes and are: W. n = 39; IM. n = 19; TAR. n = 23. Conclusion The above data shows continuing value of the IBDoc® faecal calprotectin self-test, and there is correlation seen in the comparative results. This data also helps separate well from unwell patients, offering further opportunities to promote supported self-management in people with IBD and prioritisation of clinic appointments.

scholarly journals 860 Distal Radius Fracture Management in A DGH Do the Guidelines Fit?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Thumbadoo ◽  
B Patel ◽  
J Fennelly ◽  
S Kitaoka ◽  
F Adamu-Biu ◽  
...  
Keyword(s):  
General Hospital ◽  
Distal Radius ◽  
Regional Anaesthesia ◽  
District General Hospital ◽  
Smartphone Application ◽  
Great Difficulty ◽  
Distal Radial Fractures ◽  
Local District ◽  
Retrospective Audit ◽  
Fracture Management

Abstract Aim Distal radial fractures are common injuries within adults at a variety of ages. The best treatment option remains a debated subject. The BOAST guidelines aim to guide the initial management of these fractures in the emergency department we audited against these guidelines in a local district general hospital. Method A retrospective audit was performed of adult patients with distal radius fractures who attended in December 2019, at a local district General Hospital. Patients were identified by using the Orthopaedic Take lists. Notes were reviewed for patient demographics, quality of documentation of neurovascular status, documentation of fracture information, including further management. Results There were 16 cases identified, 87.5% were female with mean age of 63 with over 56 % in the over 65s category. Only 19% of cases had appropriately documented neurovascular status. 57% were lacking specific documentation of each nerve as per BOAST guidelines, as well as 57% had no documentation of radial pulse. With regards to reductions undertaken in ED only 44% were documented if reduction took place. Of the reductions that were documented 66% documented type of analgesia used. 17% used regional anaesthesia as preferred in BOAST guidelines. Conclusions Overall compliance with BOAST guidelines was poor. Several areas to improve were seen, for which the recent launch of a new in-house smartphone application is aimed to improve access to BOAST guidelines. There was great difficulty in achieving the BOAST guidance with regards to the use of regional anaesthesia, nationally most A&E departments reduce these fractures under a haematoma block.

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