Surash S, Robertson I, Calvey T A J, Kessel D, Patel J, Kent P J, Berridge D, Scott D J A, Kester R C
Department of Vascular Surgery, St James's University Hospital, Beckett Street, Leeds, LS9 7TF, U.K.
Eur J Vasc Endovasc Surg. 2003 Jun;25(6):573-7. doi: 10.1053/ejvs.2002.1923.
in 1996 the Royal College of Radiologists established a set of guidelines for out of hours radiology. Part of the recommendations determined that all units should regularly assess their own out of hours workload. In light of these guidelines we have audited our units interventional radiology activity.
this was a retrospective study looking at the number of emergency angiograms and procedures performed over a 1-year period. Patients were identified from a vascular radiology database and case notes reviewed.
a total of 1902 patients had angiograms with 686 having further procedures. Of these, 1093 patients (57%) having 380 procedures (55%) were under the care of a consultant vascular surgeon. Of the vascular surgical patients only 17 patients (1.6%) were actually investigated out of hours (1700-0800 weekdays and at weekends). 5/17 (29%) patients received thrombolysis and 7/17 (41%) had either an angioplasty or stent. Despite being a major vascular unit only 2/17 (12%) were patients referred from outside the units own trust. Following diagnostic angiography, 13/17 (76%) of patients had an intervention performed within the first 24h.
in a unit performing a large number of angiograms only a small number of patients require out of hours emergency angiography and interventional vascular procedures. Our impression is that this is the result of a flexible and responsive in hour's service. At the present time extra-hospital referrals do not appear to generate large amounts of out of hours work. This level of out of hours activity has implications in the provision of vascular radiological services in the future.
1996年,皇家放射科医师学院制定了一套非工作时间放射学指南。部分建议规定,所有科室应定期评估自身的非工作时间工作量。鉴于这些指南,我们对本单位的介入放射学活动进行了审核。
这是一项回顾性研究,观察了1年期间进行的急诊血管造影和手术数量。从血管放射学数据库中识别患者,并查阅病历。
共有1902例患者进行了血管造影,其中686例接受了进一步手术。其中,1093例患者(57%)接受了380例手术(55%),由血管外科顾问医生负责治疗。在血管外科患者中,只有17例患者(1.6%)实际在非工作时间(工作日1700 - 0800以及周末)接受检查。17例中有5例(29%)患者接受了溶栓治疗,7例(41%)进行了血管成形术或植入了支架。尽管本单位是主要的血管科室,但17例中只有2例(12%)是来自本单位信托机构以外转诊的患者。诊断性血管造影后,17例中有13例(76%)患者在24小时内接受了干预治疗。
在一个进行大量血管造影的科室中,只有少数患者需要非工作时间的急诊血管造影和介入血管手术。我们的印象是,这是灵活且响应迅速的工作时间内服务的结果。目前,院外转诊似乎不会产生大量的非工作时间工作量。这种非工作时间活动水平对未来血管放射学服务的提供具有影响。