Edinburgh OrthopaedicTrauma Database
In-patient database
| |
| In-patients |
| |
| 1988 – 2004 |
| Every admission to Trauma Unit |
| Recorded for previous 24 hour period |
| 08.00 Trauma meeting |
| |
Out-patient database
| |
| Out-patients |
| |
| 1990 – 2004 |
| Every patient referred from Emergency or |
| from family physicians |
| Virtually every fracture (few toes missed) |
| Information taken from the ‘blue sheet’. |
| Not always accurate eg: scaphoid fractures |
| |
In-patient database
| |
| Information recorded |
| Name |
| Address |
| Hospital number |
| Gender |
| Date of admission |
| Date of birth |
| Age |
| Admitting surgeon |
| |
| Diagnosis |
| Site of injury |
| Type of surgery |
| Implant used |
| Site of injury |
| Mechanism of injury |
| Gustilo grade |
| Admission code |
| Additional code |
In-patient database -Diagnosis
| |
| Fracture type |
| Dislocation |
| Soft tissue injury |
| Arthritis |
| Spinal disorder |
| Infection |
| Metabolic problem |
| Neurological |
| Skeletal disorder |
| Primary tumour |
| Secondary tumour |
| Vascular problem |
| Post trauma complication |
| Implant problems |
| |
In-patient database –Diagnosis
Fractures
| |
| Ankle |
| Medial malleolus 254 |
| Lateral malleolus 255 |
| Bimalleolar 256 |
| Trimalleolar 257 |
| |
| Tibia and fibula |
| Proximal end 334 |
| Proximal shaft 335 |
| Midshaft 336 |
| Distal shaft 337 |
| Distal end 338 |
| |
| Radius |
| Head and neck 314 |
| Shaft 315 |
| Distal end 316 |
| Distal end (articular) 317 |
| |
| Femur |
| Head fracture 265 |
| Neck-undisplaced 266 |
| Neck-displaced 267 |
| Neck-basal 268 |
| Gtr/lesser trochanter 269 |
| Intertrochanteric 270 |
In-patient database –Diagnosis
Other diagnoses
| |
| Arthritis |
| Ankylosing spondylitis 003 |
| Gout 006 |
| Haemophilia 007 |
| Infective - pyogenic 009 |
| Infective – viral 010 |
| Osteoarthritis 014 |
| Pseudogout 016 |
| Psoriasis 017 |
| Reiters syndrome 018 |
| Rheumatoid 019 |
| |
| Metabolic |
| Diabetes 202 |
| Hyperparathyroidism 209 |
| Osteomalacia 212 |
| Rickets 213 |
| Others 215 |
| |
| Trauma complications |
| ARDS 850 |
| MOF 851 |
| DIC/Bleeding 852 |
| Fat embolus 853 |
| |
In-patient database-Diagnosis
Site of injury
| |
| Bone |
| Joint |
| Ligament |
| Muscle/tendon |
| Nerve |
| Nerve plexus |
| Nerve root |
| Connective tissue |
| Calcaneus 001 |
| Carpal bone (not sc/lu) 002 |
| Clavicle 003 |
| Femur 004 |
| Fibula 011 |
| Humerus 014 |
| Lunate 019 |
| Metacarpals 028 |
| Metatarsals 040 |
| Patella 045 |
| Pelvis 046 |
In-patient database
| |
| Surgical code |
| Soft tissue surgery |
| Joint surgery |
| Fracture surgery |
| Dislocation surgery |
| Amputation surgery |
| Cast application 300 |
| Cast + MUA 301 |
| Skin traction 305 |
| Skeletal traction 306 |
| Open reduction 331 |
| ORIF 333 |
| ORIF and graft 334 |
| ORIF + lig repair 335 |
| ORIF + cement 336 |
| Ex fix 340 |
| Removal int fixation 350 |
| Removal ex fix 351 |
| Compartment monitor 520 |
In patient database
| |
| Implant code |
| Fracture implant |
| Arthroplasty |
| Hemi-arthroplasty |
| Ligaments |
| Spine |
| Asnis screws 001 |
| AO nails 002 |
| AO screws only 003 |
| AO plate/ screws 004 |
| Herbert screw 011 |
| DHS 022 |
| Grosse Kempf nail 010 |
| |
| K nail 012 |
| Smith Peterson nail 024 |
| Watson Jones nail 028 |
| Zickel nail 030 |
In-patientdatabase
Site of injury
| |
| Home |
| Outside |
| Institution |
| Work related |
| Sports |
| RTA |
| Assault |
| Suicide |
| No injury |
| |
| Amateur football |
| Professional football |
| Occasional football |
| Rugby |
| Cricket |
| Skiing |
| Artificial skiing (Hillend) |
| Running/ Jogging |
| Athletics |
| Martial arts |
| Swimming |
| Motor sport |
| Climbing |
| Other |
In-patient database
| |
| Additional codes |
| Stress |
| Pathological |
| Fracture dislocation |
| Osteochondral |
| Non-union |
| Intra-articular |
| Post-implant |
| Mal-union |
| Epiphyseal |
| |
| Admission codes |
| Emergency admission to ITU |
| Emergency admission - A and E |
| Admission via out-patients |
| Admission - other ward/hospital |
| Admission from waiting list |
| Re-admission |
| |
Out patient Database
| |
| Name |
| Address |
| Date of Birth |
| Age |
| Gender |
| Date of presentation |
| Injury |
In-patient database
| |
| Example |
| |
| Tourist knocked down by slow-moving |
| automobile in central Edinburgh. |
| Sustains a closed fracture of |
| tibia and fibula |
Example
| |
| Name Augusto Sarmiento |
| Address Florida, USA |
| Number 007 |
| |
| DoB Secret |
| Compound code 0 |
| Additional code 1(stress) |
| Admission code 6 (interesting referral) |
Example
| |
| Primary diagnostic code 341 (Tibia and fibula diaphysis) |
| Secondary diagnostic code 070 (Tibia) |
| Surgical code 932 (Compartment monitor) |
| Surgical code 300 (application of cast) |
| Accident aetiology code 580 (RTA pedestrian) |
| |
| |
Example
| |
| |
| Surgical code 301 (closed reduction) |
| |
| Surgical code 300 (application of cast or brace) |
| or |
| Surgical code 010 (Intra-medullary nail) |
Example
| |
| Uncomplicated union - 16 weeks |
| No knee pain |
| Full joint mobility |
| Back to work 6 weeks |
| |
| Convert to intramedullary nailing |
| The power of the Edinburgh Database |
Edinburgh OrthopaedicTrauma Unit
Lower limb databases
Edinburgh OrthopaedicTrauma Unit
Upper limb databases
Year 2000 fractures
| |
| All fractures in 2000 |
| In-patient and out-patient |
| All classified |
| |
| Fracture incidence curves |
| Basic fracture epidemiology |
Databases
| |
| All very well |
| |
| But it still comes down to people, interest |
| and enthusiasm |