Abstract
When patients attend the emergency department with facial fractures that require surgery
and are immediately admitted, surgery can be delayed as theatre time is prioritised
for other more urgent patients. One solution is to send the patient home and admit
them as an elective patient at a later date. The aim of this study was to investigate
the outcomes of patients admitted directly and those seen as elective patients following
fracture of the mandible or zygomatic complex. Data were taken from the hospital episodes
statistics (HES) dataset for 2011-2018, and all hospital admissions for mandibular
and zygomatic complex fractures within the National Health Service (NHS) in England
were extracted. Patients were categorised as those admitted on attendance at the emergency
department and given definitive treatment during the admission, and those not admitted
on attendance at the emergency department but discharged home and seen as elective
admissions within 30 days of attendance. Data were available for 39 606 patients.
For both types of fracture there was substantial variation between NHS trusts in the
proportion of patients admitted electively and the proportion admitted directly as
emergencies. Elective admission was independently associated with shorter overall
stay and lower emergency readmission rates. We found no evidence that delays to definitive
surgery through elective admission had a negative impact on emergency readmission
rates. Patients admitted electively had a significantly shorter hospital stay.
Keywords
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Article info
Publication history
Published online: August 14, 2020
Accepted:
July 31,
2020
Identification
Copyright
© 2020 Published by Elsevier Ltd on behalf of The British Association of Oral and Maxillofacial Surgeons.
