Outcome and Cost Evaluation of Hip Fractures in Elderly Patients at a Tertiary Care Hospital in the Caribbean.

Introduction Hip fractures in the elderly are considered one of the most common types of orthopedic injuries, associated with increased morbidity and mortality. The incidence has been increasing over the years, and its management has also caused a significant economic burden for most countries worldwide. This study aimed to determine the outcomes and economic costs associated with hip fractures in elderly patients at a tertiary care institution in Trinidad and Tobago.

The Prevalence of Violence Against Healthcare Workers in Trinidad and Tobago.

Background: Abuse of healthcare workers (HCWs) and lack of public trust threaten the foundation of the physician-patient relationship. This growing global problem creates an even more difficult professional environment and hinders the delivery of high-quality clinical care.

Objective: The primary aim was to determine the prevalence of violence against Trinbagonian HCWs in the public sector.

Experiences with SARS-CoV-2 (Covid-19) in Trinidad and Tobago, a small island developing state: realities and opportunities.

The COVID-19 pandemic has exerted significant global challenges that are expressed in a variety of socio-politico-economic scenarios, depending upon individual countries' preparedness and resilience. The impact COVID-19 in Small Island Developing States (SIDS), most of which are categorized as Lower and Middle-Income Countries, has been pronounced. Furthermore, many of these SIDS possess specific vulnerabilities to global threats.

An Economic Evaluation of the Preoperative Investigations for Elective Surgical Patients at a Caribbean Tertiary Care Teaching Hospital.

Introduction Preoperative assessment using widespread laboratory investigations and ancillary tests as preoperative screening may be unnecessary and lead to an economic burden. This study aimed to determine the routine preoperative investigations performed in a tertiary care teaching hospital in the Caribbean that could be categorized as unnecessary and the costs incurred for these tests. Methods Patient and surgery-specific data were collected prospectively from adult elective surgery patients over a three-month period.

Knowledge, Attitudes and Practices (KAP) regarding the Novel Coronavirus Disease (COVID-19) Post-lockdown in Trinidad and Tobago.

The Novel Coronavirus Disease (COVID-19) was declared a pandemic by the World Health Organization (WHO) in March 2020. Trinidad and Tobago reported its first infection on March 12 2020. This study assessed knowledge, attitudes and practices toward COVID-19 among Trinidadians during the post-lockdown period.

A qualitative exploration of value and waste in a Trinidadian emergency department patient flow process: perspectives of patients and clinicians.

Purpose: A process that does not include the customer's value may not be effective in providing care. This study aimed to identify value and waste in an emergency department (ED) patient flow process from a patient and clinician perspective.

Design/methodology/approach: A qualitative case study was conducted in an ED in Trinidad and Tobago.

Costs of Providing Intensive Care for Adult Non-survivors in a Caribbean Teaching Hospital.

Introduction  Intensive Care Unit (ICU) is a resource intense area consuming a vast majority of the hospital's budget. This study aimed to determine the costs of providing critical care to non-survivors in an adult ICU at a tertiary care teaching hospital in the Caribbean. Methods  A chart review of non-survivors over a period of nine months was done in an adult ICU.

Qualitative exploration of patient flow in a Caribbean emergency department.

Objectives: Emergency departments (EDs) are complex adaptive systems and improving patient flow requires understanding how ED processes work. This study aimed to explore the patient flow process in an ED in Trinidad and Tobago, identifying organisational factors influencing patient flow.

Methods: Multiple qualitative methods, including non-participant observations, observational process mapping and informal conversational interviews were used to explore patient flow.

Epidemiology and Management Trends of Patients With Sepsis and Septic Shock in the Intensive Care Unit: A Prospective Trial in the Caribbean.

Objectives To investigate the epidemiology, management, and predictors of mortality in severe sepsis and septic shock in the intensive care units (ICUs) of Trinidad, Trinidad & Tobago. Methods A prospective observational study in four ICUs over a one-year period (August 2017-August 2018) was conducted. Physiologic variables, treatment data, and outcomes were collected on admission to ICU and daily until 28 days.

The Impact of Sociodemographic and Socioeconomic Factors on the Burden of Cataract in Small Island Developing States (SIDS) in the Caribbean from 1990 to 2016.

To study the impact of sociodemographic and socioeconomic factors on the cataract burden in Caribbean small island developing states (SIDS) using disability-adjusted life-years (DALYs). National and regional age and sex specific cataract DALY numbers and rates from 1990 to 2016 for Caribbean SIDS, were extracted from the Global Burden of Disease Study 2016. The human development index (HDI), healthcare access and quality (HAQ) index, and the World Bank's classification of economies were used as socioeconomic status indicators.

Detecting Major Complications and Death After Emergency Abdominal Surgery Using the Surgical Apgar Score: A Retrospective Analysis in a Caribbean Setting.

Objective: The Surgical Apgar Score (SAS) is a simple 10-point scoring system that has been shown to be predictive of major postoperative complications and death after surgery. We evaluated the predictive ability of this score in a cohort of patients undergoing emergency abdominal surgery in a Caribbean tertiary hospital.

Methods: The SAS was calculated retrospectively from the anaesthesia records of all patients undergoing emergency abdominal surgery during a 12-month period.

[Emergence delirium following sevoflurane anesthesia in adults: prospective observational study].

Background And Objectives: Emergence delirium after general anesthesia with sevoflurane has not been frequently reported in adults compared to children. This study aimed to determine the incidence of emergence delirium in adult patients who had anesthesia with sevoflurane as the volatile agent and the probable risk factors associated with its occurrence.

Design & Methods: A prospective observational study was conducted in adult patients who had non-neurological procedures and no existing neurological or psychiatric conditions, under general anesthesia.

Interventions to improve patient flow in emergency departments: an umbrella review.

Objectives: Patient flow and crowding are two major issues in ED service improvement. A substantial amount of literature exists on the interventions to improve patient flow and crowding, making it difficult for policymakers, managers and clinicians to be familiar with all the available literature and identify which interventions are supported by the evidence. This umbrella review provides a comprehensive analysis of the evidence from existing quantitative systematic reviews on the interventions that improve patient flow in EDs.

Impact of a medical university on laparoscopic surgery in a service-oriented public hospital in the Caribbean.

Introduction: The Caribbean lags behind global trends for volume and complexity of laparoscopic operations. In an attempt to promote laparoscopy at a single facility, a partnership was formed between the University of the West Indies (UWI) and the Port of Spain General Hospital in Trinidad and Tobago. This study seeks to document the effect of this partnership on laparoscopic practice.

Does preoperative psychological status of patients affect postoperative pain? A prospective study from the Caribbean.

Objectives: Patients with high anxiety states in the preoperative period often have more intense postoperative pain, despite adequate pain control during the intraoperative period. This study aimed to determine the relationship between the preoperative psychological status and the pain experienced postoperatively in a sample of Caribbean patients.

Design And Methods: A prospective study was conducted in elective surgical adult patients at a teaching hospital in the Caribbean.

Efficacy of a separate informed consent for anesthesia services: A prospective study from the Caribbean.

Background And Aims: This study aimed to determine whether a separate written consent form improved the efficacy of the informed consent process for anesthesia in adult patients undergoing elective surgery at a tertiary care teaching hospital.

Material And Methods: We randomized patients into two groups prospectively. The first group (Group A) signed the hospital's standard Consent for Operation form only while the second group (Group B) signed a separate Consent for Anesthesia form additionally.

Costs and Utilization of Operating Rooms in a Public Hospital in Trinidad, West Indies.

Context: A top-down evaluation of the costs of operating rooms (ORs) is not commonly done because it is relevant mostly in a publicly funded system.

Objective: This study was conducted to determine the costs and utilization of ORs in a public hospital in Trinidad, West Indies, for two one-year periods using a top-down model.

Design: Quantitative observational study.

Do Serially Recorded Prognostic Scores Predict Outcome Better Than One-Time Recorded Score on Admission? A Prospective Study in Adult Intensive Care Patients.

Objectives: The prognosticating ability of one-time recorded Acute Physiology and Chronic Health Evaluation (APACHE) IV score was compared with serially recorded Mortality Prediction Model (MPM) II scores.

Design And Methods: A prospective observational study was conducted for a period of 6 months. Acute Physiology and Chronic Health Evaluation IV score was recorded during the first day on intensive care unit (ICU) admission.

Laparoscopic Repair of Sportman's Hernia - The Trinidad Experience.

Sportman's hernia: (Athletic pubalgia) is an uncommon and poorly understood condition afflicting athletic individuals. Sufferers complain of chronic groin pain and often present diagnostic dilemmas to physicians and physiotherapists. We present a series of cases illustrating the varying presentations of sportman's hernia and diagnostic approaches that can be utilized to exclude common differentials.

The economic impact of hospitalization for diabetic foot infections in a Caribbean nation.

Context: Foot infection is the most common complication of diabetes mellitus in the Caribbean. Diabetic foot infections place a heavy burden on health care resources in the Caribbean.

Objective: To evaluate the treatment-related costs for diabetic foot infections in a Caribbean nation.