Background Waiting times for surgery, post-operative hospital inpatient stays and complication rates vary between hospitals. A regional audit group in rheumatology has conducted a survey to compare services for rheumatology patients.
Objectives To compare operation waiting times, post operative complication rates and management of rheumatology drug therapies during inpatient stays for rheumatolgy patients.
Methods Rheumatologists from seven hospitals completed an audit form on consecutive patients in rheumatology outpatient departments over six months. Information on details of all orthopaedic procedures, waiting times, inpatient stays, complications, concurrent rheumatological drug therapies was obtained from medical records and from patients themselves (inflammatory joint disease was primary diagnosis in 81%).
Results A total of 406 orthopaedic operations were performed in 293 patients, 106 total knee replacements (26%), 71 total hip replacements (17.5%), 48 wrist/hand joint operations (12%), 27 forefoot arthroplasties (6.7%), 15 shoulder replacements (3.7%), 14 elbow replacements (3.4%), 12 ankle fusions (3%) and the remainder miscellaneous.
The main post operative complications which resulted in increased lenght of inpatient stay were wound sepsis (17), chest infection (4), deep vein thrombosis (4) joint dislocation/fracture (3). Main second line drugs were sulphasalzine (65) and methotrexate (58) and steroids were used by 39 patients. Figures will show differences between centres for waiting times (median 9 months) and inpatient stays (median 7 days).
Conclusion Marked variations in waiting times could be identified to specific local difficulties which are being addressed. Cessation or changes in second line drugs were uncommon and created only short lasting problems, but need to be reviewed regularly.