Évaluation de la programmation en chirurgie ambulatoire des fractures de l’extrémité distale du radius à l’Hôpital Sud de Grenoble en 2016 : une grande marge de progression accessible

Abstract : Introduction: Ambulatory surgery is currently undergoing major development. Along with this highly codified mode of care, traumatology orthopedics also has great potential in this area. In 2014, the High Health Authority (HAS) specified the conditions of eligibility. The objective of this work was to determine the potential of outpatient surgery on the distal radius fracture (FEIR) cohort at the southern Grenoble Hospital in 2016. The secondary objective was to test the influence of different factors on the outpatient rate for this cohort. Method: The report of the HAS has been studied in order to list the criteria of eligibility of the patients. The data relating to these criteria were collected in the patient files operated in 2016 for FEIR at the Grenoble South Hospital. Patient eligibility status was defined retrospectively and compared to the type of care provided. Secondly, various factors were statistically tested by Chi2 and Fisher supprimer tests to determine their potential effects on the proportion of patients effectively managed on an outpatient basis. Results: The series included 208 patients. The proportion of outpatient surgery actually performed was 17.3%. The total proportion of eligible patients on the series was 70.7%. Bed availability did not significantly change this proportion, neither the school period nor the distance to the center. In contrast, the age group of the patients over 70 years significantly modified the ambulatory rate (p= 0.024). Discussion: This study confirms a major potential for the outpatient management of FEIRs. However, it concerns a small series of patients, limiting the statistical power of the tests. Moreover, the analysis of eligibility retrospectively is potentially biased. Further study would refine this figure and extend the potential analysis to other orthopedic traumatology gestures.
Document type :
Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01943412
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Submitted on : Monday, December 3, 2018 - 5:29:54 PM
Last modification on : Wednesday, February 27, 2019 - 10:58:02 PM

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Jean-Yves Delahaye. Évaluation de la programmation en chirurgie ambulatoire des fractures de l’extrémité distale du radius à l’Hôpital Sud de Grenoble en 2016 : une grande marge de progression accessible. Médecine humaine et pathologie. 2018. ⟨dumas-01943412⟩

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