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

NCT05097066 | Completed

• 1 other identifier: NNAP002
• Study Type: observational
• Target: 371,418
• Locations: 0 countries
• Sites: N/A

Brief 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.

Conditions

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

Outcome Measures

Primary Outcomes (4)

• 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.

• 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.

• 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.

• 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.

Study Arms (2)

Elective neurosurgery

Any elective neurosurgical procedure.

Procedure: Neurosurgical procedure

Non-elective neurosurgery

Any non-elective neurosurgical procedure.

Procedure: Neurosurgical procedure

Interventions

Neurosurgical procedure PROCEDURE

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

Elective neurosurgery; Non-elective neurosurgery

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All admissions to neurosurgical units in the National Health Service (NHS) in England. This covers any patients in England who required neurosurgical care, except those admitted to Private Providers of neurosurgical care.

You may qualify if:

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

You may not qualify if:

• Records with poor quality data (e.g. no data for clinical diagnoses).
• Patients under 18 years that were admitted to an adult neurosurgical unit.

Sponsors & Collaborators

• University of Leeds: lead
• The Royal College of Surgeons of England: collaborator

MeSH Terms

Conditions

Nervous System Diseases

Interventions

Neurosurgical Procedures

Intervention Hierarchy (Ancestors)

Surgical Procedures, Operative

Study Officials

• Ryan Mathew

  University of Leeds

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor and Consultant Neurosurgeon

Study Record Dates

• First Submitted: September 14, 2021
• First Posted: October 27, 2021
• Study Start: April 1, 2013
• Primary Completion: March 31, 2018
• Study Completion: March 31, 2018
• Last Updated: October 27, 2021

Record last verified: 2021-10

Data Sharing

• IPD Sharing: Will not share