Relationship between travel time to primary and tertiary care centres and survival in glioblastoma: the NHS Grampian experience.

Abstract Background Studies have demonstrated a distance-decay effect, whereby patients who live further away from their healthcare facility have poorer health outcomes. The geographical catchment area served by the neurosurgical unit in Aberdeen, Grampian region, Scotland is one of the largest in the UK. We aimed to examine the relationship between travel time as a proxy of distance travelled, and survival outcome for glioblastoma. Methods We conducted a retrospective, cohort analysis of patients with glioblastoma referred for treatment from January 2009 to December 2018. Travel time was calculated from the patients’ home to their general practitioner (GP) and to the neurosurgical unit. Logistic regression models were constructed to estimate survival at three, six and 12 months, as well as treatment within 62 days of GP referral, and within 31 days of diagnosis controlling for age, sex and treatment type. Results There were 195 patients (mean age (SD) 64.4 ± 12.9 years)57.9% were men, 65.1% were treated surgically, and 48.2% were alive after one year. Longer time travelled to GP, but not to tertiary care centre, was associated with reduced odds of mortality at three months (OR 0.88 95%CI 0.79–0.98; p=0.005) and six months (OR 0.92 95%CI 0.85–0.99; p=0.01), for each incremental increase in one minute. Conclusions Patients with glioblastoma with longer travel times to their GP were more likely to be alive at three months and six months. Further work is required to identify other factors, including degrees of socio-economic deprivation and rurality, which may influence this finding.

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325 Pretibial Injury and 1 Year Mortality

British Journal of Surgery ◽

10.1093/bjs/znab259.694 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

D Peberdy

Keyword(s):

Plastic Surgery ◽

Cohort Analysis ◽

Frail Patients ◽

Retrospective Cohort Analysis ◽

Hospital Patients ◽

The Difference ◽

Student’S T ◽

One Year ◽

The Uk ◽

Surgery Department

Abstract Aim Frailty is increasingly recognised as an important factor for patients under the care of surgical departments. Pre-tibial injury is a common presenting problem to plastic surgery units across the UK. We wanted to assess the 1-year mortality of this patient cohort presenting to our unit. Method Retrospective cohort analysis of prospectively maintained clinical database across a calendar year from June 2017 to June 2018. This was perforemd at a UK Regional Plastic Surgery Centre analysinig patients presenting to the Royal Devon and Exeter Hospital. Patients were scored as either frail (Rockwood ≥ 5) or Non-Frail (Rockwood ≤ 4) taken from initial clinical assessment proformas. Results A total of 85 patients were included in the study. Mean age was 76.4 (± 18 years), and mean Rockwood Frailty Score of 3.4. Across all patients presenting to the plastic surgery department with pre-tibial injury there was a 20% (17/85) mortality at one year. In frail patients 1 year mortality was 47.6% (10/21). In Non-Frail patients 1 year mortality was 10.9% (7/64). The difference in mortalitly at 1 year was found to be significantly different in Frail vs Non-Frail patients with P = 0.00009 in an unpaired Student's t Test. Conclusions Frailty is a common condition in patients presenting with pre-tibial injury. This is a significant predictor of 1 year mortality in patients presenting with pre-tibial injury. Standardised evidence-based pathways of care for these patients could help optimise their management. Opportunities for MDT involvement in their care may improve outcomes.

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A retrospective cohort analysis on the management of percutaneous drains for intra-abdominal sepsis at a Canadian tertiary care centre

10.26226/morressier.596648e4d462b80290b52118 ◽

2017 ◽

Author(s):

Jeremy Springer

Keyword(s):

Retrospective Cohort ◽

Cohort Analysis ◽

Tertiary Care ◽

Abdominal Sepsis ◽

Care Centre ◽

Tertiary Care Centre ◽

Retrospective Cohort Analysis

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Pattern of Ear Diseases among Paediatric ENT Patient: An Experience from Tertiary Care Centre, Pokhara, Nepal

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v32i2.5673 ◽

2012 ◽

Vol 32 (2) ◽

pp. 142-145 ◽

Cited By ~ 2

Author(s):

B Sigdel ◽

R Nepali

Keyword(s):

Tertiary Care ◽

Age Group ◽

Care Centre ◽

Tertiary Care Centre ◽

Suppurative Otitis Media ◽

Ear Diseases ◽

Paediatric Age ◽

One Year ◽

A Prospective Study ◽

Nose And Throat

Introduction: Ear diseases are common in children mainly due to altered anatomy of Eustachian tube which is straighter in children as compared to that in adults. However, the cause of hearing loss in children is more varied, including the etiologies. This study was done to find out the pattern of ear diseases in paediatric age group attending ear, nose and throat OPD in a tertiary care centre in Pokhara, Nepal. Materials and Methods: This is a prospective study done in paediatric patients attending ENT OPD over a period of one year from January 2010 to January 2011. The diagnoses were made on the basis of history and clinical examination. Results were expressed in numbers and percentages. Results: Out of 1632 Pediatric ENT patients, 944 had ear diseases, 59.2% were males and 40.8% females. Wax (33.4%) was the commonest diagnosis followed by Chronic suppurative otitis media (24.3%) and Acute ottitis media (13%). Conclusion: Ear diseases are most common condition in ENT OPD among paediatric age group. Wax, CSOM and ASOM were the three most common ear diseases. J. Nepal Paediatr. Soc. 32(2) 2012 142-145 doi: http://dx.doi.org/10.3126/jnps.v32i2.5673

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Type and mode of diagnosis of carcinoma lung in a tertiary care centre: one year experience

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20174940 ◽

2017 ◽

Vol 5 (11) ◽

pp. 4891

Author(s):

Jayaprakash Balakrishnan ◽

Sindhu Nair Prasannakumari ◽

Ajith Achuthan ◽

John Mathew

Keyword(s):

Lung Cancer ◽

Cell Carcinoma ◽

Small Cell Carcinoma ◽

Tertiary Care ◽

Small Cell ◽

Common Type ◽

Ultra Sound ◽

Tertiary Care Centre ◽

Easy Method ◽

One Year

Background: Lung cancer is one of the commonest cancers and cause of cancer related deaths all over the world. The reported incidence of adenocarcinoma is increasing globally and now reported to be the most common type of lung cancer. A panel of investigations are used for the diagnosis of lung cancer. Hence a study was planned to find out the pattern of malignancy and the most appropriate investigation for diagnosis. Objective of present study was to find out the type of carcinoma lung and to find out the best and easy method for diagnosis of carcinoma lung in a tertiary care centre.Methods: A hospital based cross sectional study was conducted in one unit of the Department of Pulmonary Medicine, Government Medical college, Thiruvananthapuram for a period of one year.148 diagnosed cases of carcinoma lung were enrolled. The type and the methods used for diagnosis were analysed.Results: Adenocarcinoma was the commonest malignancy 57 (38.5%), followed by squamous cell carcinoma 44 (29.7%) and small cell carcinoma 10 (6.75%). Rest of the cases 37 (25%) include non small cell carcinoma, poorly differentiated carcinoma and lymphoma. Diagnosis was established by FNA Lung in 46 (31.1%) patients and bronchoscopy and biopsy in 41 (27.7%). Other methods include TBNA 12 (8.1%), lymph node FNA/biopsy 11 (7.4%), pleural fluid cytology 24 (16.2%), sputum cytology and tru cut biopsy 14 (9.5%).Conclusions: The most common type of lung malignancy in present study was adenocarcinoma. Ultra sound guided FNAC lung and bronchoscopy biopsy were the best methods in present study to confirm the diagnosis.

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A PROSPECTIVE OBSERVATIONAL STUDY OF CLINICAL PROFILE IN ETIOLOGY OF ANEMIA IN ELDERLY-A HOSPITAL BASED STUDY IN A TERTIARY CARE CENTRE IN SOUTH INDIA

International Journal of Advanced Research ◽

10.21474/ijar01/13508 ◽

2021 ◽

Vol 9 (09) ◽

pp. 961-972

Author(s):

K. Shivaraju ◽

◽

Karanam Sai Arun ◽

Mandhala Saikrishna ◽

◽

...

Keyword(s):

Tertiary Care ◽

The Elderly ◽

Moderate Degree ◽

Care Hospital ◽

Tertiary Care Centre ◽

Total Study Population ◽

Study Population ◽

Poor Outcomes ◽

One Year ◽

Severe Degree

Background: Anemia is often considered as a normal physiological process that occurs with aging. but recently since past 2 decades anemia of any degree is being recognized as significant independent contributor to morbidity mortality and frailty in elderly patients. It is easy to overlook anemia in elderly as symptoms of anemia like fatigue, SOB etc are often attributed to aging process itself. many evidences accumulated states that anemia of any degree reflects poor health and increased vulnerability to poor outcomes. Materials and methods: This study was conducted in the department of internal medicine in a tertiary care hospital over a period of one year with sample size of 362 subjects satisfying the inclusion and exclusion criteria after taking the consent form. Results: Moderate degree anaemia was the commonest around, 65.6% followed by severe degree anemia 20.1%. Easy fatigability was the commonest symptom and pallor was the commonest sign of anaemia in elderly. Anemia is not always a consequence of aging. Anemia of unexplained etiology constituted 15.97% of total study population. Conclusion: Anaemia in elderly is a challenge and has to be approached in an organized manner for appropriate diagnosis and evaluation to look into its cause and plan management to improve the quality of life of the elderly persons.An effort should always be made to reach etiological diagnosis before instituting specific therapy.

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Primary cemented bipolar hemiarthroplasty by transtrochanteric approach in unstable intertrochanteric fractures

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20212362 ◽

2021 ◽

Author(s):

Thomas Angelo Skariah ◽

Koshy George ◽

Deny Mathew ◽

James C. George ◽

Samuel Chittaranjan

Keyword(s):

Elderly Patients ◽

Successful Treatment ◽

Tertiary Care ◽

Postoperative Outcome ◽

Early Mobilization ◽

Bipolar Hemiarthroplasty ◽

Intertrochanteric Fractures ◽

Tertiary Care Centre ◽

Duration Of Surgery ◽

One Year

Background: The successful treatment of unstable intertrochanteric fractures of the femur in elderly patients is a challenge. Due to complications associated with internal fixation, primary hemiarthroplasty is increasingly becoming an alternative treatment to achieve early mobilisation. A transtrochanteric approach could potentially decrease the complications associated with primary hemiarthroplasty. Aim of the study is to document the postoperative outcome and complications associated with this treatment.Methods: In this retrospective study, all elderly patients with unstable trochanteric fractures, treated by primary hemiarthroplasty through a transtrochanteric approach, in a tertiary care centre, from September 2017 to December 2019, were enrolled. Their data from hospital records were analysed and results compared to literature.Results: 48 patients underwent the procedure. Average age was 85 years. One year mortality was 31.25%. Average duration of surgery is 85 min. 58.3% were ambulant at one year. One case of dislocation secondary to surgical site infection was present.Conclusions: Primary hemiarthroplasty as a primary treatment in this group of patients enables early mobilization and prevents complications associated with prolonged immobilization. Transtrochanteric approach reduces the duration of surgery. Achieving early ambulation is the key to successful treatment.

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TO ANALYSE THE DEFERRAL INCIDENCE AND ITS PATTERN AMONG THE BLOOD DONORS IN A TERTIARY CARE CENTRE IN NORTH INDIA.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i8.445 ◽

2019 ◽

Vol 3 (8) ◽

Author(s):

Dr. Surbhi Jain

Keyword(s):

Blood Donor ◽

Blood Donors ◽

Blood Donation ◽

Selection Process ◽

Tertiary Care ◽

Clinical History ◽

North India ◽

Tertiary Care Centre ◽

One Year ◽

Donor Deferral

Background: Blood donor programme is vital to any transfusion service. This process of blood donation involves voluntary and non remunerated blood donors. The objective of donor screening is to minimize the chances of transmitting infectious agents to recipients. Material and Method: The study was conducted during one year duration from 2017-2018. A total of 700 donors are deferred against 9556 blood donors recruited on the basis of clinical history and brief medical examination in blood bank and voluntary blood donation camps. Donors were deferred temporarily or permanently. Result: Out of 700 deferred donors; 546 were voluntary and 154 were replacement blood donors. Male (601) outnumbered female (99). There were 682 temporary and 18 permanent deferral. Most common age group for deferral was 17-30 yrs (490). Common causes included anemia(142), on medication(108), underweight(83) and high blood pressure(72). Conclusion: Donor selection process is a most important preliminary step in blood banking and should follow stringent medical and regulatory rules. Studying and analysing the profile of blood donors will help to identify sections of the population which could be targeted to increase the pool of voluntary blood donors. Every attempt should be made to decrease the donor deferral keeping in view the safety of both donor and recipients. Keywords: Blood donor, Deferral, Voluntary, Temporary, Permanent.

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