From research to practice: results of 7300 mortality retrospective case record reviews in four acute hospitals in the North-East of England

Introduction: Suicide rates have risen in England over the last decade and hanging, a highly lethal method of suicide, has been the most common method. Previous work in this area identified a lack of literature discussing emergency medical services (EMS) attendance at hangings. This article aims to describe hangings attended by EMS in the North East of England in order to inform future work in this area.Methods: A retrospective service evaluation was conducted using existing data from a comprehensive pre-hospital trauma audit database to describe patients with hanging documented in their records who were attended by ambulance clinicians between 1 December 2018 and 31 November 2020.Results: Hanging was recorded in 604 incidents. Most cases (n = 579/604) involved adults (aged 18 years or older) with a median age of 35 years (IQR 27‐45 years), who were male (n = 410/579, 71%). Just over half (n = 341/579, 59%) of adult hangings resulted in cardiac arrest and of these, 10% (n = 33/341) were resuscitated and survived to hospital admission. Threatened and non-fatal hangings appear to have increased dramatically in the latter half of 2020. Previous suicide attempts and mental health issues were frequently reported across this population.Conclusion: Hangings are a method of suicide which frequently result in a cardiac arrest. In the North East of England the ambulance service attends approximately one hanging per day and one fatal hanging every two days. When fatal hangings were resuscitated, pre-hospital outcomes were similar to other causes of cardiac arrest, highlighting that despite the traumatic nature of these cases resuscitation is not futile. In order to better understand this patient group and improve care, pre-hospital data need to be linked to data from other services such as mental health services and acute hospitals.

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Young-Onset Colorectal Cancer in the North East of Scotland: Survival, Clinico-Pathological Features and Genetics

10.21203/rs.2.14759/v2 ◽

2020 ◽

Cited By ~ 1

Author(s):

Sarah Perrott ◽

Kirsten Laurie ◽

Kirsten Laws ◽

Annie Johnes ◽

Zosia Miedzybrodzka ◽

...

Keyword(s):

Colorectal Cancer ◽

Advanced Disease ◽

Survival Rates ◽

Significant Proportion ◽

Genetic Services ◽

Retrospective Case ◽

Young Onset ◽

Inherited Cancer ◽

North East ◽

The North

Abstract Background Colorectal cancer (CRC) in patients aged under 55 years is on the rise, constituting approximately 10% of cases. Our aim was to determine the survival and clinico-pathological details of young-onset CRC (yCRC), as well as audit the referral rate to genetic services and thus establish the incidence of inherited cancer syndromes. Methods A retrospective case note review was conducted for patients aged under 55 years who were diagnosed with CRC between 2005-2015 in the North East of Scotland. Cases were identified by pathology records and data was obtained from patient notes then crosschecked with the NHS Grampian genetics electronic case records. Analysis was performed using SPSS version 25 (IBM, New York, USA) to produce Kaplan-Meier survival estimates, descriptive statistics and markers predictive for genetic referral. Results Data from 345 patients (age range 22-54 years) were identified. The one year, five year and overall survival rates were found to be 89%, 63% and 55%, respectively. Most patients (61%) presented with advanced disease. Of 201 patients that met criteria for genetic referral, only 93 (46%) were referred to genetics services. Microsatellites instability (MSI) was identified in 14% of those referred. Conclusions Survival in yCRC was found to be better than that in later onset disease, despite higher rates of advanced disease. Patients were under-referred to genetic services, where a significant proportion were found to be MSI positive and investigated for Lynch syndrome.

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Complications after Thoracocentesis and Chest Drain Insertion: A Single Centre Study from the North East of England

Journal of Respiration ◽

10.3390/jor1020014 ◽

2021 ◽

Vol 1 (2) ◽

pp. 135-140

Author(s):

Karl Jackson ◽

Opeyemi Kafi ◽

Dilraj Bhullar ◽

Jordan Scott ◽

Claire Storey ◽

...

Keyword(s):

Pleural Cavity ◽

Case Series ◽

Categorical Variables ◽

British Thoracic Society ◽

Chest Drain ◽

Complication Rates ◽

Continuous Variables ◽

Retrospective Case ◽

North East ◽

The North

Introduction: There are no prospective studies looking at complications of pleural procedures. Previous British Thoracic Society Pleural audits and retrospective case series inform current practice. Incidence of any complication is between 1–15%. We sought to add to the existing literature and inform local practice with regards to intercostal drains and thoracocenteses. Methods: Local Caldicott approval was sought for a review of all inpatient adult pleural procedures coded as ‘T122 drainage of pleural cavity’ and ‘T124 insertion of tube drain into pleural cavity’. Those undergoing thoracocentesis (all with a Rocket 6 Fg catheter) and intercostal drain insertion (ICD, all with Rocket 12 Fg drain) were identified. Continuous variables are presented as mean (±range) and categorical variables as percentages where appropriate. Results: 1159 procedures were identified. A total of 199 and 960 were done for pneumothorax and effusions respectively. Mean age was 68.1 years (18–97). There were 280 thoracocenteses and 879 ICDs. Bleeding occurred in 6 (0.5%), all ICDs (clotting and platelets were within normal range; one patient was on aspirin and one on aspirin and clopidogrel). All settled except for one who had intercostal artery rupture needing cardiothoracic intervention (no anti-coagulation). Nine pneumothoraces occurred (0.78%) in seven ICDs and two aspirations). There were three definite pleural space infections (0.3%) with three ICDs. Fall out rates for ICDs were 35 (3%). Nine were not sutured, and out of those, seven inserted in the Accident and Emergency department, out of hours. All others ‘came out’ due to patient factors (previous quoted rates up to 14%). Surgical emphysema occurred in 43 (41 ICDs), 3.7%. Eight were due to fall outs and three required surgical intervention. There was no re-expansion pulmonary oedema nor direct deaths. Conclusions: Complication rates of ICD and thoracocenteses are low. Checklists might help to remind operators of the need for suturing. Limitations of this study are its retrospective nature and reliance on correct hospital coding. We are currently contributing to a prospective observational study on pleural complications.

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Young-Onset Colorectal Cancer in the North East of Scotland: Survival, Clinico-Pathological Features and Genetics

10.21203/rs.2.14759/v1 ◽

2019 ◽

Author(s):

Sarah Perrott ◽

Kirsten Laurie ◽

Kirsten Laws ◽

Annie Johnes ◽

Zosia Miedzybrodzka ◽

...

Keyword(s):

Colorectal Cancer ◽

New York ◽

Survival Rates ◽

Significant Proportion ◽

Genetic Services ◽

Retrospective Case ◽

Young Onset ◽

North East ◽

The North ◽

Kaplan Meier

Abstract Background Colorectal cancer (CRC) in patients aged under 55 years is on the rise, constituting approximately 10% of cases. Our aim was to determine the survival and clinico-pathological details of young-onset CRC (yCRC), as well as audit the referral rate to genetic services and thus establish the incidence of microsatellite instability (MSI). Methods A retrospective case note review was conducted for patients aged under 55 years who were diagnosed with CRC between 2005-2015 in the North East of Scotland. Cases were identified by pathology records and data was obtained from patient notes then crosschecked with the NHS Grampian genetics electronic case records. Analysis was performed using SPSS version 25 (IBM, New York, USA) to produce Kaplan-Meier survival estimates, descriptive statistics and markers predictive for genetic referral. Results Data from 345 patients (age range 22-54 years) were analysed. The one year, five year and overall survival rates were found to be 89%, 63% and 55%, respectively. A majority of patients (61%) presented with advanced Dukes’ C or D disease. Of 201 patients that met criteria for genetic referral, only 93 (46%) were referred to genetics services. MSI was identified in 14% of those referred. Conclusions Survival in yCRC was found to be better than that in later onset disease, despite higher rates of advanced disease. Patients were under-referred to genetic services, where a significant proportion were found to be MSI positive.

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Pneumothorax and/or Pneumomediastinum Worsens the Prognosis of COVID-19 Patients with Severe Acute Respiratory Failure: A Multicenter Retrospective Case-Control Study in the North-East of Italy

Journal of Clinical Medicine ◽

10.3390/jcm10214835 ◽

2021 ◽

Vol 10 (21) ◽

pp. 4835

Author(s):

Matteo Bonato ◽

Alessia Fraccaro ◽

Nicholas Landini ◽

Giuseppe Zanardi ◽

Cosimo Catino ◽

...

Keyword(s):

Respiratory Failure ◽

Case Control ◽

Control Group ◽

Control Analysis ◽

Retrospective Case ◽

Mechanically Ventilated ◽

North East ◽

The North ◽

Incidence Risk ◽

Case Control Analysis

Pneumothorax (PNX) and pneumomediastinum (PNM) are potential complications of COVID-19, but their influence on patients’ outcomes remains unclear. The aim of the study was to assess incidence, risk factors, and outcomes of severe COVID-19 complicated with PNX/PNM. Methods: A retrospective multicenter case-control analysis was conducted in COVID-19 patients admitted for respiratory failure in intermediate care units of the Treviso area, Italy, from March 2020 to April 2021. Clinical characteristics and outcomes of patients with and without PNX/PNM were compared. Results: Among 1213 patients, PNX and/or PNM incidence was 4.5%. Among these, 42% had PNX and PNM, 33.5% only PNX, and 24.5% only PNM. COVID-19 patients with PNX/PNM showed higher in-hospital (p = 0.02) and 90-days mortality (p = 0.048), and longer hospitalization length (p = 0.002) than COVID-19 patients without PNX/PNM. At PNX/PNM occurrence, one-third of subjects was not mechanically ventilated, and the respiratory support was similar to the control group. PNX/PNM occurrence was associated with longer symptom length before hospital admission (p = 0.005) and lower levels of blood lymphocytes (p = 0.017). Conclusion: PNX/PNM are complications of COVID-19 associated with a worse prognosis in terms of mortality and length of hospitalization. Although they are more frequent in ventilated patients, they can occur in non-ventilated, suggesting that mechanisms other than barotrauma might contribute to their presentation.

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Ras al Khaimah: further archaeological discoveries

Antiquity ◽

10.1017/s0003598x00150070 ◽

1976 ◽

Vol 50 (200) ◽

pp. 216-222

Author(s):

Beatrice De Cardi

Keyword(s):

United Arab Emirates ◽

The State ◽

Focused Attention ◽

North East ◽

The North ◽

History Of ◽

The City

Ras a1 Khaimah is the most northerly of the seven states comprising the United Arab Emirates and its Ruler, H. H. Sheikh Saqr bin Mohammad al-Qasimi, is keenly interested in the history of the state and its people. Survey carried out there jointly with Dr D. B. Doe in 1968 had focused attention on the site of JuIfar which lies just north of the present town of Ras a1 Khaimah (de Cardi, 1971, 230-2). Julfar was in existence in Abbasid times and its importance as an entrep6t during the sixteenth and seventeenth centuries-the Portuguese Period-is reflected by the quantity and variety of imported wares to be found among the ruins of the city. Most of the sites discovered during the survey dated from that period but a group of cairns near Ghalilah and some long gabled graves in the Shimal area to the north-east of the date-groves behind Ras a1 Khaimah (map, FIG. I) clearly represented a more distant past.

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