Biography

Sara A Kreindler published latest article in Canadian journal of surgery. Journal canadien de chirurgie entitled Regional consolidation of orthopedic surgery: impacts on hip fracture surgery access and outcomes. This article is available in PubMed with an unique identification number PMID: 28930037 and it is published in 2017. The coauthors of this article are Kreindler SA, Siragusa L, Bohm E, Rudnick W, Metge CJ.


Research Interest

Healthcare


Latest Publication Details

Article Title: Regional consolidation of orthopedic surgery: impacts on hip fracture surgery access and outcomes.

Co-Author(s): Kreindler SA, Siragusa L, Bohm E, Rudnick W, Metge CJ

Affiliation(s): From the Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man. (Kreindler, Bohm, Metge); the George and Fay Yee Centre for Healthcare Innovation, University of Manitoba and Winnipeg Regional Health Authority, Winnipeg, Man. (Kreindler, Bohm, Metge); the College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man. (Siragusa); the Department of Surgery, University of Manitoba and Winnipeg Regional Health Authority, Winnipeg, Man. (Bohm); the Concordia Hip and Knee Institute, Winnipeg Regional Health Authority, Winnipeg, Man. (Bohm); and the St. Boniface Hospital, Winnipeg, Man. (Rudnick).

PMID 28930037, Year 2017

Abstract: Timely access to orthopedic trauma surgery is essential for optimal outcomes. Regionalization of some types of surgery has shown positive effects on access, timeliness and outcomes. We investigated how the consolidation of orthopedic surgery in 1 Canadian health region affected patients requiring hip fracture surgery.We retrieved administrative data on all regional emergency department visits for lower-extremity injury and all linked inpatient stays from January 2010 through March 2013, identifying 1885 hip-fracture surgeries. Statistical process control and interrupted time series analysis controlling for demographics and comorbidities were used to assess impacts on access (receipt of surgery within 48-h benchmark) and surgical outcomes (complications, in-hospital/30-d mortality, length of stay).There was a significant increase in the proportion of patients receiving surgery within the benchmark. Complication rates did not change, but there appeared to be some decrease in mortality (significant at 6 mo). Length of stay increased at a hospital that experienced a major increase in patient volume, perhaps reflecting challenges associated with patient flow.Regionalization appeared to improve the timeliness of surgery and may have reduced mortality. The specific features of the present consolidation (including pre-existing interhospital performance variation and the introduction of daytime slates at the referral hospital) should be considered when interpreting the findings.En traumatologie, lacc?s rapide ? la chirurgie orthop?dique est essentiel pour lobtention de r?sultats optimaux. La r?gionalisation de certains types de chirurgie a eu des effets positifs sur lacc?s aux soins, leur rapidit? et leurs r?sultats. Nous avons v?rifi? leffet qua eu la consolidation des soins chirurgicaux orthop?diques dans une r?gion sanitaire canadienne sur les patients qui ont eu recours ? la chirurgie pour une fracture de la hanche.Nous avons obtenu les donn?es administratives concernant toutes les consultations dans les services durgence r?gionaux pour des blessures aux membres inf?rieurs et nous les avons corr?l?es avec les s?jours hospitaliers de janvier 2010 ? mars 2013. Nous avons ainsi recens? 1885 chirurgies pour fracture de la hanche. Nous avons utilis? la ma?trise statistique des proc?d?s et le mod?le chronologique interrompu et nous avons tenu compte des caract?ristiques d?mographiques et des comorbidit?s pour ?valuer les impacts sur lacc?s aux interventions (attente limite de 48 h pour obtenir la chirurgie) et leurs r?sultats (complications, mortalit? perhospitali?re ? 30 j et dur?e des s?jours).On a not? une augmentation significative de la proportion de patients trait?s par chirurgie ? lint?rieur des d?lais. Les taux de complications nont pas vari?, mais il semble y avoir eu une certaine diminution de la mortalit? (significative ? 6 mois). La dur?e des s?jours a augment? dans un h?pital qui a connu un accroissement majeur de sa client?le, t?moignant peut-?tre de difficult?s li?es ? lafflux de patients.La r?gionalisation a sembl? am?liorer lacc?s rapide ? la chirurgie et pourrait avoir r?duit la mortalit?. Il faut tenir compte des caract?ristiques sp?cifiques de la pr?sente consolidation (y compris la variation pr?existante du rendement interhospitalier et la cr?ation de listes de jour ? lh?pital de r?f?rence) avant dinterpr?ter ces conclusions.

Journal: Canadian journal of surgery. Journal canadien de chirurgie

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