Wishaw General Hospital

About: Wishaw General Hospital is a healthcare organization based out in Wishaw, Scotland, United Kingdom. It is known for research contribution in the topics: Population & Survival rate. The organization has 256 authors who have published 222 publications receiving 4324 citations.

Postoperative critical care and high-acuity care provision in the United Kingdom, Australia, and New Zealand

Abstract: Background Decisions to admit high-risk postoperative patients to critical care may be affected by resource availability. We aimed to quantify adult ICU/high-dependency unit (ICU/HDU) capacity in hospitals from the UK, Australia, and New Zealand (NZ), and to identify and describe additional ‘high-acuity' beds capable of managing high-risk patients outside the ICU/HDU environment. Methods We used a modified Delphi consensus method to design a survey that was disseminated via investigator networks in the UK, Australia, and NZ. Hospital- and ward-level data were collected, including bed numbers, tertiary services offered, presence of an emergency department, ward staffing levels, and the availability of critical care facilities. Results We received responses from 257 UK (response rate: 97.7%), 35 Australian (response rate: 32.7%), and 17 NZ (response rate: 94.4%) hospitals (total 309). Of these hospitals, 91.6% reported on-site ICU or HDU facilities. UK hospitals reported fewer critical care beds per 100 hospital beds (median=2.7) compared with Australia (median=3.7) and NZ (median=3.5). Additionally, 31.1% of hospitals reported having high-acuity beds to which high-risk patients were admitted for postoperative management, in addition to standard ICU/HDU facilities. The estimated numbers of critical care beds per 100 000 population were 9.3, 14.1, and 9.1 in the UK, Australia, and NZ, respectively. The estimated per capita high-acuity bed capacities per 100 000 population were 1.2, 3.8, and 6.4 in the UK, Australia, and NZ, respectively. Conclusions Postoperative critical care resources differ in the UK, Australia, and NZ. High-acuity beds may have developed to augment the capacity to deliver postoperative critical care.

Chronic pain following a Lichtenstein inguinal hernia repair: a clinical and legal dilemma.

Abstract: Background: Chronic pain following a Lichtenstein inguinal hernia is frequent and raises major concerns regarding informed consent recall Objective: To assess the frequency of chronic pain and associated factors following inguinal hernia repair in a district general hospital. To assess patient recall of the consent process as it pertains to chronic pain. Methods: A random sample (170/293 patients) of those who underwent a Lichtenstein inguinal hernia repair between 2002 and 2004 were retrospectively assessed for the frequency, intensity and other co-factors of chronic pain. They were also questioned about their recollection of the consent process and information given regarding chronic pain. Results: 50 percent of patients reported chronic pain at a median follow-up of 62 months with 30% reporting a significant impact on daily activities. Younger age, the absence of a lump at presentation, pre-operative pain and elective repair were the only factors significantly shown to increase the likelihood of post-operative pain. Patients with post-operative pain were significantly more likely to report that they had not been informed of the possibility of chronic pain pre-operatively or at the time of consent. Twenty percent of these patients stated that they would not have undergone the operation if they had been informed of the possibility of chronic pain. Conclusion: Chronic pain is frequent and debilitating. Documentation of chronic pain as a possible outcome at the time of consent should be mandatory as patient recall is poor.

Haemochromatosis gene mutations and risk of coronary heart disease: a west of Scotland coronary prevention study (WOSCOPS) substudy

Abstract: Objectives: To measure the frequency of genotypes of the HFE (haemochromatosis) gene in patients recruited to the west of Scotland coronary prevention study (WOSCOPS), and relate them to the subsequent occurrence of coronary clinical events. Design: Nested case–control study, drawing samples of DNA from the biological bank of a cohort study. Patients: Men aged 45–64 years in 1989, with moderate hypercholesterolaemia and no evidence of coronary heart disease at baseline. Interventions: Follow up for a mean period of 4.9 years. Typing for C282Y and H63D mutations of the HFE gene in 482 subjects with a subsequent coronary event and 1104 without an event. Results: The C282Y mutation was present in 81 of 482 cases (16.8%) and 182 of 1104 controls (16.5%). Comparing the prevalence of gene mutations in the cases and controls, there were no significant differences. The hazard ratio for C282Y heterozygotes was 1.03 (95% confidence interval (CI) 0.77 to 1.36) and for C282Y/H63D compound heterozygotes 1.04 (95% CI 0.50 to 2.14). Prespecified subgroup analyses of the pravastatin, placebo, smoking, and non-smoking groups showed no significant differences between cases and controls. Repeating the analyses after adjusting for possible confounding factors produced no change in the results. Conclusions: In a population of moderately hypercholesterolaemic middle aged Scottish men who did not have any evidence of coronary heart disease at baseline, the presence of a C282Y mutation in the HFE gene did not predict the occurrence of coronary events over a mean follow up of 4.9 years.

The epidemiology of Scottish trauma: A comparison of pre-hospital and in-hospital deaths, 2000 to 2011.

Abstract: Aims To characterise the temporal trends and urban-rural distribution of fatal injuries in Scotland through the analysis of mortality data collected by the National Records of Scotland. Methods The prospectively collected NRS database was queried using ICD-10 codes for all Scottish trauma deaths during the period 2000 to 2011. Patients were divided into pre-hospital and in-hospital groups depending on the location of death. Incidence was plotted against time and linear regression was used to identify temporal trends. Results A total of 13,100 deaths were analysed. There were 4755 (36.3%) patients in the pre-hospital group with a median age (IQR) of 42 (28–58) years. The predominant cause of pre-hospital death related to vehicular injury (27.8%), which had a decreasing trend over the study period (p = 0.004). In-hospital, patients had a median age of 80 (58–88) years and the majority (67.0%) of deaths occurred following a fall on the level. This trend was shown to increase over the decade of study (p = 0.020). In addition, the incidence of urban incidents remained static, but the rate of rural fatal trauma decreased (p Conclusions Around a third of Scottish trauma patients die prior to hospital admission and the predominant mechanism of injury is due to road traffic accidents. This contrasts with in-hospital deaths, which are mainly observed in elderly patients following a fall from standing height. Further research is required to determine the preventability of fatal traumatic injury in Scotland.