E007 Novel signs to predict healthcare consumption following bone fracture: a clinical audit

Abstract

Abstract Background/Aims Recovery following fracture is variable. Previously we have identified poor outcomes based upon baseline abnormal body scheme. We now aimed to determine whether these novel bedside tests measuring finger perception abnormalities and body scheme disruption can be used to predict healthcare utilisation post fracture. Methods We performed two bedside tests in patients who were in cast in the plaster room. We followed up clinical records for 2+ years and gathered data on the use of healthcare resources from both hospital and primary care electronic patient records. The novel tests were a finger perception (FP) and body scan (BS) assessment. The audit was approved by Cambridge University Hospitals (PRN8899). Results 46 patients were included. 2 had incomplete data and were excluded from the final analysis. 25 patients (group 1) had no abnormalities in their body scheme at baseline in the fracture room. 16 had a single abnormality and 3/44 (group 2, 7%) had both FP and BS. This final group consumed more analgesics, took longer to discharge and had a greater utilisation of healthcare resources (Table 1). Comparing the cost difference using NHS 2020 Reference costs between groups 1 and 2 was around £530/patient. Annually this equates to £175,000 for CUH. Conclusion FS and BS are easy to assess in patients with a bone fracture and predict a cohort which expressed more pain and health care consumption. Upscaling the difference between the normal and abnormal groups would incur an annual trust and primary care cost of £175,000. Disclosure R. Mudkavi: None. N. Shenker: None.