Clinical Complexity and its role in Trauma Care: Validation of AO Principles of Care
Sunny Deo’s research was recognised as the best research presentation at this year’s British Trauma Society Meeting, held in Sheffield in early November 2017. His award winning presentation is based on clinical data collection from the Orthopaedic department prior to the start of national hip fracture data, which suggests a pragmatic “real-world” system of measuring clinical complexity fits with previously taught principles which have not been so easy validate using traditional big data series. It highlights the importance of careful clinical data collection and suggests certain factors not commonly captured in standard datasets can and do influence the outcomes for a given condition, in this case patients with hip fractures.
Method and patients:
Over the past 8 years we have undertaken a number of clinical projects centred on clinical complexity and the interaction between 2 principle factors namely local and systemic, generating a 4 part classification of clinical complexity.
This equates to “injury factors and patient factors” of traditional AO/ ASIF (Association for the Study of Internal Fixation) teaching. We further refined these by setting criteria for these factors being straightforward or complex, thereby creating a 2×2 matrix of clinical complexity, with C0 as the most straightforward type of case and C3 the most complex.