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German Congress of Orthopaedics and Traumatology (DKOU 2023)

24. - 27.10.2023, Berlin

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It is (not) always on friday – inter-hospital patient transfers in orthopedic and trauma surgery

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  • presenting/speaker Jonas Roos - Uniklinikum Bonn, Orthopädie & Unfallchirurgie, Bonn, Germany
  • Thomas Loy - Uniklinikum Bonn, Orthopädie & Unfallchirurgie, Bonn, Germany
  • Milena Plöger - Uniklinikum Bonn, Orthopädie & Unfallchirurgie, Bonn, Germany
  • Leonie Weinhold - Universität Bonn, Institut für Medizinische Biometrie, Informatik und Epidemiologie (IMBIE), Bonn, Germany
  • Christian Prangenberg - Uniklinikum Bonn, Orthopädie & Unfallchirurgie, Bonn, Germany
  • Martin Gathen - Uniklinikum Bonn, Orthopädie & Unfallchirurgie, Bonn, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2023). Berlin, 24.-27.10.2023. Düsseldorf: German Medical Science GMS Publishing House; 2023. DocEV13-3272

doi: 10.3205/23dkou677, urn:nbn:de:0183-23dkou6775

Published: October 23, 2023

© 2023 Roos et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives: While inter-hospital transfers for patients that suffered a major trauma is well investigated, patient flows for other injured patients or cases with an orthopedic complication are rarely described. This study aims to analyze the affected collective and to show possible reasons, patterns and pitfalls to optimize the process in future.

Methods: In a prospective cohort study all consecutive transferals to a level I trauma center in Germany were documented and assessed. Patients suffering a major trauma were excluded. Data on the primary treating hospital, patient characteristics and differences between emergency and elective surgery were analyzed.

Results: A total of 227 patients were included, 162 were injured, 65 suffered a complication after elective orthopedic surgery or had a complex orthopedic pathology.

Most common diagnosis that led to a transfer were, pathologies of the extremities (n=62), pathologies of the spine (n=50), and infections (n=18). Main reasons stated by the transferring hospitals were al lack of expertise in 137 cases and a lack of capacity in 43 cases. There was a significant higher rate of transfers due to a trauma (n=162, p<0.0001).

Conclusion: There is currently no structured procedure or algorithm for transferring patients with orthopedic and trauma.