Patterns and Outcomes of Neurosurgery in England Over a Five-year Period

Surgery Clinical Trial

Official title:

Patterns and Outcomes of Neurosurgery in England Over a Five-year Period: a National Retrospective Cohort Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05097066
• Other study ID #: NNAP002
• Status: Completed
• Start date: April 1, 2013
• Est. completion date: March 31, 2018

Study information

• Verified date: October 2021
• Source: University of Leeds
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Neurosurgical practice has seen many important changes over several decades with advances in treatments and the types of patients treated. Neurosurgical procedures have evolved, and as outcomes have improved the number of patients being treated has increased.

There are no recent evaluations of national neurosurgical practice in the United Kingdom (UK), with the last prospective cohort studies being Safe Neurosurgery 1993 and Safe Neurosurgery 2000. More recent studies of neurosurgical services have been based on data from single institutions or surgeons and these may not give a representative picture of practice nationally.

Recent national quality improvement programmes for neurosurgery in England (such as the National Neurosurgical Audit Programme (NNAP) and Cranial Neurosurgery and Spinal Surgery Getting It Right First Time (GIRFT) Programmes) have focused on using national hospital administrative datasets. To be effective, quality improvement initiatives require robust outcome measures and quality (process) indicators. Currently, there is a lack of validated quality indicators for neurosurgery, with practice often being described using generic measures such as readmission and reoperation rates and length of stay. Many studies have been able to derive these common outcome measures, but it may also be possible to produce indicators specific to neurosurgery.

The aim of this observational study was firstly to describe the current pattern of neurosurgical admissions and procedures in England, and thereby given an overview of the epidemiology of neurosurgical patients. Secondly, it aims to investigate the range of outcome measures that might be produced from hospital administrative data and use these to assess the quality of care in neurosurgery.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 371418
• Est. completion date: March 31, 2018
• Est. primary completion date: March 31, 2018
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• All admissions to neurosurgical units in the National Health Service (NHS) in England.

Exclusion Criteria:

• Records with poor quality data (e.g. no data for clinical diagnoses).

• Patients under 18 years that were admitted to an adult neurosurgical unit.

Related Conditions & MeSH terms

• Comorbidities and Coexisting Conditions
• Disease
• Morality
• Nervous System Diseases
• Neurological Complication
• Neurological Diseases or Conditions
• Neurological Disorder
• Neurological Morbidity
• Outcome, Fatal
• Surgery
• Surgery--Complications

Intervention

Procedure:
• Neurosurgical procedure
Any neurosurgical procedure in the National Neurosurgical Audit Programme (NNAP) Coding Framework of neurosurgical procedures.

Locations

Country	Name	City	State
n/a

Sponsors (2)

Lead Sponsor	Collaborator
University of Leeds	The Royal College of Surgeons of England

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Length of stay	Length of the hospital admission to neurosurgery	From date of admission to date of discharge from hospital; assessed up to 60 months.
Primary	Additional inpatient neurosurgical procedure rate	A further neurosurgical procedure in admissions where patients have had a primary (main) neurosurgical procedure.	From date of admission to date of discharge from hospital; assessed up to 60 months.
Primary	Proportion of patients discharged home	Proportion of patients discharged to their normal address.	Determined on date of discharge from hospital; assessed up to 60 months.
Primary	In-patient mortality rate	In-patient mortality after a neurosurgical procedure.	From date of the neurosurgical procedure through date of death from any cause (in-patient deaths only); assessed up to 60 months.