支持区域上肢关节成形术：建立上肢骨科网络的影响
Supporting Regional Upper Limb Arthroplasty: The Impact of Establishing an Upper Limb Orthopaedic Network.
作者信息
Oakley Ben, Marson Ben, Wijeratna Malin, Manning Paul, Geoghegan John, Gooding Ben
机构信息
Nottingham Shoulder and Elbow Unit, Nottingham University Hospitals NHS Foundation Trust, City Hospital Campus, Nottingham, UK.
出版信息
J Shoulder Elb Arthroplast. 2024 Oct 29;8:24715492241258623. doi: 10.1177/24715492241258623. eCollection 2024.
BACKGROUND AND OBJECTIVES
The management of complex upper limb arthroplasty has received national guidelines supporting the use of a regional network. An upper limb network was established for both elbow and shoulder arthroplasty. This study evaluates the impact of establishing this network over a 5-year period.
METHODS
Data were collected from network meetings from June 2017 to December 2022. Hospital-level National Joint Registry data were obtained for analysis of case volume.
RESULTS
A total of 243 cases were discussed. Network discussion changed the management plan in 53% of cases. Only 8% of cases required transfer to the tertiary center. The proportional caseload at either hub or spoke hospitals did not change after creation of the network.
DISCUSSION
Regional network discussion aids decision-making for complex cases, with further management options realized in over half of the cases presented. The discussion allowed every patient to gain the advantage of regional expertise while being managed conveniently at their local hospital.
背景与目的
复杂上肢关节置换术的管理已获得支持区域网络使用的国家指南。已建立了针对肘关节和肩关节置换术的上肢网络。本研究评估了在5年期间建立该网络的影响。
方法
收集了2017年6月至2022年12月网络会议的数据。获取医院层面的国家关节注册数据以分析病例数量。
结果
共讨论了243例病例。网络讨论在53%的病例中改变了管理计划。仅8%的病例需要转至三级中心。网络建立后，枢纽医院或分支医院的病例比例没有变化。
讨论
区域网络讨论有助于复杂病例的决策制定，在所呈现的超过一半的病例中实现了进一步的管理选择。该讨论使每位患者在当地医院得到便利管理的同时，能够受益于区域专业知识。
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