Abstract
Introduction
Traditionally complex spinal surgery in Belfast has been performed at the Royal Victoria Hospital (RVH). Since an amalgamation the RVH has become effectively the level 1 trauma centre for the province. The ever increasing complexity of spinal surgery in addition to changes in practice such as the management of metastatic spinal cord, are placing significant demands on the service. At a time when resources are scarce trends in patient profiles are highly important to allow adequate planning of our service.
Aim
To establish trends in patient profiles in a level one trauma centre also managing spinal pathology over the last 10 years and to examine the impact of this on our service.
Methods
The Fracture Outcome Research Data base (FORD) was interrogated to provide data for patient profiles from 2000 to 2010. The Hospital planning and performance department contacted for finance data.
Results
In 2000 the most common admission was for a fractured neck of femur (n=1014). This has not significantly changed over the ten years. In 2000 fractured tibia (n= 386), fractured forearms (n= 324), fractured ankles (n= 312) and spinal cases (n=335) were admitted. By 2010 a 49% increase had occurred in spinal admissions making them the second most common patient admitted to the unit. Of spinal case admissions, tumours have increased by 333%, spinal fractures by 10%, cervical disc surgery by 163% and suspected cauda equine cases by a staggering 537%.
Conclusions
The throughput of spinal admissions to the unit has significantly increased between 2000 and 2010 making them now the second most common admission to the unit. The impact of this on bed days, theatre usage and oncall arrangements is huge and must be taken into account in stratregic planning of our service especially given the background of ongoing financial constraint.
