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

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.

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Key information

Conditions

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

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

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.

Treatment and study plan

Neurosurgical procedure

Procedure

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

Primary outcomes

Length of stay

Time frame: From date of admission to date of discharge from hospital; assessed up to 60 months.

Length of the hospital admission to neurosurgery
Additional inpatient neurosurgical procedure rate

Time frame: From date of admission to date of discharge from hospital; assessed up to 60 months.

A further neurosurgical procedure in admissions where patients have had a primary (main) neurosurgical procedure.
Proportion of patients discharged home

Time frame: Determined on date of discharge from hospital; assessed up to 60 months.

Proportion of patients discharged to their normal address.
In-patient mortality rate

Time frame: From date of the neurosurgical procedure through date of death from any cause (in-patient deaths only); assessed up to 60 months.

In-patient mortality after a neurosurgical procedure.

Sponsors and collaborators

Lead sponsor

University of Leeds

Other

Collaborators

The Royal College of Surgeons of England

Registry information

Official study title

Patterns and Outcomes of Neurosurgery in England Over a Five-year Period: a National Retrospective Cohort Study

Important dates

Study start: 2013
Primary completion: 2018
Study completion: 2018
First posted: Oct 27, 2021
Registry last updated: Oct 27, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

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