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

NCT ID: NCT05097066

Last Updated: 2021-10-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

371418 participants

Study Classification

OBSERVATIONAL

Study Start Date

2013-04-01

Study Completion Date

2018-03-31

Brief Summary

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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.

Detailed Description

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Conditions

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Surgery Surgery--Complications Neurological Morbidity Neurological Diseases or Conditions Neurological Disorder Neurological Complication Neurological Procedural Complication Outcome, Fatal Comorbidities and Coexisting Conditions Morality

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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Elective neurosurgery

Any elective neurosurgical procedure.

Neurosurgical procedure

Intervention Type PROCEDURE

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

Non-elective neurosurgery

Any non-elective neurosurgical procedure.

Neurosurgical procedure

Intervention Type PROCEDURE

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

Interventions

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Neurosurgical procedure

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

Intervention Type PROCEDURE

Eligibility Criteria

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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.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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The Royal College of Surgeons of England

OTHER

Sponsor Role collaborator

University of Leeds

OTHER

Sponsor Role lead

Responsible Party

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Ryan Mathew

Associate Professor and Consultant Neurosurgeon

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ryan Mathew

Role: STUDY_CHAIR

University of Leeds

Other Identifiers

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NNAP002

Identifier Type: -

Identifier Source: org_study_id