Author(s): Foster M.; May P.
Source: British Journal of Neurosurgery; 2018; vol. 32 (no. 1); p. 107
Publication Date: 2018
Publication Type(s): Conference Abstract
Abstract:Objectives: Anecdotally it is felt the emergency referral throughput is increasing. Furthermore, it was suspected that more elderly patients, unsuitable for neurosurgical intervention, are being referred. Design: Retrospective service analysis. Subjects: All adult patients referred to tertiary neurosurgical centre between 1/12/14 to 8/2/17. Methods: Analysis of ‘ORION’ (Outcome Registry Intervention and Operation Network) referrals database. Results: There were 15709 calls over 1103 days, representing 12257 individual patients referred and 3452 instances of patients being re-discussed. On average 11 new patients were referred per day, with 14 calls per day. There were 6904 calls logged in 2015, and 7456 in 2016, representing an 8% increase. Diagnosis was be classified as vascular (20%), tumour (19%) trauma (29%) infection (3%), degenerative spine (18%), and no neurosurgical problem (4%). 17% of patients referred were accepted for transfer urgently to our unit, 24% were to be reviewed as an outpatient, in MDT, or by senior specialists, and 60% were advised to be managed locally. 11% of calls were regarding octogenarians. Of this cohort, only 3% were accepted for transfer. Conclusions: Analysis of the ORION is a powerful tool for assessing a unit’s emergency workload. The volume of emergency referrals is increasing, with a considerable proportion these being octogenarians, unsuitable for admission to a neurosurgical unit.