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Orthopedics audit 2016
Orthopedics audit 2016
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Neurosurgery audit 2016

  1. 1. Neurosurgery Department Audit-2016 Dr.Deepak Agrawal Prof. Neurosurgery JPNATC,AIIMS 06-04-2017
  2. 2. CLINICAL WORKLOAD YEAR OPD ADMISSION SURGERY BEDS 2013 6384 1661 1304 58 2014 6450 1957 1426 58 2015 6832 1881 1334 58 2016 6660 1760 1385 58 0 5000 10000 20132014 2015 2016 OPD ADMISSION SURGERY BEDS
  3. 3. JR -7 SR -15 CONSULTANT- 19 2016 2015 JR -9 SR -15 CONSULTANT- 12
  4. 4. 2013 2014 2015 2016 Total HI Total Mortality Total HI Total Mortality Total HI Total Mortality Total HI Total Mortality Severe HI 590 33.89% 604 29.3% 536 38.4% 476 14.4% Moderate HI 208 10.5% 225 7.1% 121 13.2% 174 7.9% Minor HI 423 2.3% 526 0.95% 456 4.1% 533 0.60% Total 1221 18.47% 1355 14.61% 1113 22.6% 1183 6.42 % MORTALITY IN HEAD INJURY
  5. 5. 5 2013 2014 2015 2016 Total Total Mortality Total Total Mortality Total Total Mortality Total Total Mortality Cervical Injury 240 35.06% 425 15.52% 254 7.03% 190 8 % Dorso - Lumbar Injury 200 4.5% 177 1.12 % 182 2.74 % 145 2.068% MORTALITY IN SPINAL INJURY
  6. 6. 6 2013 2014 2015 2016 Total Total Mortality Total Total Mortality Total Total Mortality Total Total Mortality Severe head injury 94 40.42% 52 32.69 % 86 34.8 % 45 8.8% Moderate HI 83 6.02% 15 0% 17 5.8 % 11 0% Minor HI 78 0% 51 0% 69 1.44% 36 0% HEAD INJURY IN PAEDIATRICS
  7. 7. 7 2014 2015 2016 Total Total Mortality Total Total Mortality Total Total Mortality Cervical Spine injury 35 22.85 28 33% 20 25% Dorso-lumbar 9 0% 5 0% 9 0% SPINAL INJURY IN PAEDIATRICS
  8. 8. 8 2013 2014 2015 2016 Mi nimu m Stay( days) Ma ximu m stay Me an stay Mi nimu m Stay( days) Max imum stay Mea n stay Mini mum Stay(d ays) Max imum stay Mean stay Mi nimu m Stay( days) Max imum stay Mean stay Minor HI 2 14 6 1 34 7.14 1 52 8.4 1 19 5 MOD ERATE HI 3 35 8 3 58 9.21 2 272 11.8 3 37 9.46 SEVE RE HI 7 60 20 3 96 18.64 1 126 16.3 7 75 20.12 HOSPITAY STAY IN HEAD INJURY ADMISSIONS
  9. 9. 9 2013 2014 2015 2016 Mini mum Stay(d ays) Maxi mum stay Mea n stay Mini mum Stay(d ays) M axi mu m sta y Mean stay M ini mu m Sta y(d ays) Maxi mum stay Mean stay Minim um Stay(day s) Maxim um stay Mean stay CERVI CAL INJURY 5 142 14 3 3 90 16 3 350 15 1 164 14.8 DORSO LUMBAR INJURY 4 92 12 3 1 02 10.38 3 45 10.25 3 68 10 HOSPITAY STAY IN SPINAL INJURY ADMISSIONS
  10. 10. YEAR De.Cran iotomy VP/ TP Shunt Crani oplast y Trache ostomy BPI Spinal Others 2013 284 68 121 77 96 316 342 2014 364 88 192 81 125 362 214 2015 270 58 112 58 132 319 207 2016 369 64 122 39 171 330 111 0 200 400 2016 2015 2014 2013
  11. 11. YEAR ICP INSERTION IN OT ICP INSERTION IN ICU 2013 05 342 2014 08 266 2015 06 324 2016 32 318 ICP INSERTION 0 200 400 IN OT IN ICU 2016 2015 2014 2013
  12. 12. YEAR OPEN TT PERCUTANEOUS TT 2013 77 290 2014 81 310 2015 58 317 2016 39 354 0 200 400 2016 2015 2014 2013
  13. 13. WARD/IC U 2016 2015 2014 2013 TC3 1186 1473 1369 1702 TC5 605 592 419 347 0 500 1000 1500 2000 TC3 TC5 2016 2015 2014 2013
  14. 14. TEG DONE 2013 1310 2014 985 2015 957 2016 593 Column1 2016 2015 2014 2013
  15. 15. Year O arm C-arm 2016 64 115 2015 112 215 2014 115 193 TOTAL O-ARM &C-ARM CASES 0 100 200 300 2016 2015 2014 O-ARM C-ARM
  16. 16. RESEARCHS AND PUBLICATIONS (2015-2016) 1. Agrawal D, Kurwale N, Sharma BS. Leukocytosis after routine cranial surgery: A potential marker for brain damage in intracranial surgery. Asian J Neurosurg. 2016;11:109-13. 2. Agrawal D, Ahmed S, Khan S, Gupta D, Sinha S, Satyarthee GD. Outcome in 2068 patients of head injury: Experience at a level 1 trauma centre in India. Asian J Neurosurg. 2016;11:143-5. 3. Kamal VK, Agrawal D, Pandey RM. Prognostic models for prediction of outcomes after traumatic brain injury based on patients admission characteristics. Brain Inj. 2016;22:1-14. 4. Agrawal D, Saini R, Singh PK, Sinha S, Gupta DK, Satyarthee GD, Misra MC. Bedside computed tomography in traumatic brain injury: Experience of 10,000 consecutive cases in neurosurgery at a level 1 trauma center in India. Neurol India. 2016;64:62-5.
  17. 17. PUBLICATIONS (2015-2016) 5. Bhoi S, Thakur N, Verma P, Sawhney C, Vankar S, Agrawal D, Sinha T. Does community emergency care initiative improve the knowledge and skill of healthcare workers and laypersons in basic emergency care in India? J Emerg Trauma Shock. 2016;9:10-6. 6. Agrawal D, Singh PK, Sinha S, Gupta DK, Satyarthee GD, Misra MC. Remaining unconscious: The burden of traumatic brain injuries in India. J Neurosci Rural Pract. 2015;6:520-2. 7. Kumar A, Verma N, Agrawal D, Sharma BS. Endoscopic lavage for antibiotic unresponsive severe Acinetobacter baumanii ventriculitis: an unexplored treatment option. Acta Neurochir (Wien). 2015;157:1225-7. 8. Mishra A, Agrawal D, Gupta D, Sinha S, Satyarthee GD, Singh PK. Traumatic spondyloptosis: a series of 20 patients. J Neurosurg Spine. 2015;22:647-52.
  18. 18. PUBLICATIONS (2015-2016) 12. Agrawal D, Sinha TP, Bhoi S. Assessment of ultrasound as a diagnostic modality for detecting potentially unstable cervical spine fractures in pediatric severe traumatic brain injury: A feasibility study. J Pediatr Neurosci. 2015;10:119-22. 13. Sinha S, Raheja A, Garg M, Moorthy S, Agrawal D, Gupta DK, Satyarthee GD, Singh PK, Borkar SA, Gurjar H, Tandon V, Pandey RM, Sharma BS. Decompressive craniectomy in traumatic brain injury: A single-center, multivariate analysis of 1,236 patients at a tertiary care hospital in India. Neurol India. 2015;63:175-83.
  19. 19. SNo Project Title Funding Agency Start Date Completed Ongoing Projects 1. Early versus Delayed Decompression for Traumatic high Cervical Spinal Cord Injury in Acute Spinal Cord Injury Study DST September 2014 September 2017 2. “Optic Nerve Ultrasound in Severe Traumatic Brain Injury” DBT December 2015 December 2018 Completed Project 1. “Thromboelastometry (TEG): Utility and Cost- effectiveness in diagnosing of infection in Neurosurgery Intensive care unit (ICU) as compared to established biomarkers” Institute Completed 2. “Determination of the reference range for the elevated PT/INR with normal coagulation factor level and its association with plasma transfusion therapy in head injury patients” ICMR June 2015 June 2016 3. “Acute thalamic involvement in severe head injury-An autopsy study with histopathological correlation” Institute Completed 4. “Matrix Metalloproteinase (MMPS) (MMPS) as biomarkers for fusion following spinal instrumentation AOSPINE 2014 2015 5. “Monitoring cognition of healthcare workers in emergency and intensive care setting and its relation to medical errors” DST 2011 2015 6. “Automated assessment of hand hygiene complication in healthcare settings using Kinect Camera” DBT 2013 2015 7. “Economic & Social burden of Managing Traumatic brain injuries (TBI) in adult aged 18-50 years in India” ICMR 2014 2015
  20. 20. INNOVATIONS DREZ • Total patients -35 (Male-33 ,Female- 02) • Pain -31 • Spasticity- 04 O-ARM DRAPE • 12-15 drape/month till July 2016 • Cloth drape from September 2016 • Total -21 drape in OT (reusable)
  21. 21. NURSING STUDIES IN NEUROSURGERY Title of study Researcher Awards Role of nurses in Thiamine administration in alcoholic head injured patients. Mr. Pankaj Paper presented NSSICON -2016 Role of Nurses in intracranial pressure monitoring by ultrasound in patients with severe traumatic brain injury. Ms. Sumi sunny Paper presented in NSSICON -2016 A study to assess the determinants of self extubation and the predictive factors for reintubation in a tertiary care Neuro Trauma ICU. Ms.Ashitha E B & Ms.Aswathy Sunil NSICON-2016 ( first Prize ) Effect of Inj.Midazolam during ET & oral suctioning Ms.Metilda Robin WTC -2016( second prize) To compare the setup time and safety of intraoperative O ARM with traditional intraoperative Fluoroscopy (C ARM) and nursing implications in Neurosurgery OT. Ms.Minju malhotra WTC-2016( THIRD PRIZE )
  22. 22. Perceptions of Neurotrauma patients family members on nursing care . Ms.Aswathy Sunil First Prize in Neuro Trauma symposium - 2016 Outcome following Cranioplasty with bone flap stored in bone bank or in Abdomen in Severe Head Injury Patients Ms.sofia solomon &Ms.Aswathy Sunil NSSICON-2016( FIRST PRIZE ) Study to assess the breach in sterility in OT Ms. Minju Ongoing NURSING STUDIES IN NEUROSURGERY
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