Immediate Interpretation and Results Communication Decreases Patient Anxiety: Experience in a Private Practice Community Hospital.

OBJECTIVE. The study objectives were to evaluate the percentage of patients interested in immediate radiologic results and to measure patient anxiety and hospital loyalty with this program in a private practice community hospital setting. SUBJECTS AND METHODS. Between December 2018 and May 2019, 100 patients 18-89 years old with a primary diagnosis of abdominal pain had imaging orders for CT, ultrasound, or nuclear medicine-hepatobiliary iminodiacetic acid scans and subsequently were asked if they wanted immediate results. Those who opted for immediate results were given a two-question survey before and after results delivery that asked about their anxiety level and imaging center loyalty. Data were entered using SurveyMonkey (SVMK) and analyzed using SAS software (version 9.4, SAS Institute). RESULTS. The majority (78%) of patients wanted immediate results. There were statistically significant differences in anxiety level before and after results delivery; 37% (p < 0.001) reported decreased anxiety after receiving imaging results, whereas 57% reported no change in anxiety (p < 0.001). The decision whether to come back to this imaging center (hospital loyalty) did not change before and after test results; 85% of participants strongly agreed that they would return. CONCLUSION. It is feasible for private practice radiologists to discuss CT, ultrasound, or nuclear medicine imaging results with patients in a community hospital setting. The majority of patients preferred immediate results over traditional methods of notification. Most patients reported anxiety about their imaging results, and a statistically significant number had decreased anxiety after discussing results with radiologists.

A Systematic Review and Meta-Analysis on Treatment of Ankle Fractures With Syndesmotic Rupture: Suture-Button Fixation Versus Cortical Screw Fixation.

Ankle fractures accompanied by syndesmotic rupture are a complex challenge for orthopedic surgeons. Sufficient reduction and stabilization of the syndesmosis are important to prevent early degeneration of the ankle joint and to optimize clinical outcomes. The purpose of the study was to systematically review the literature comparing the suture-button fixation method with the cortical screw fixation method when treating syndesmotic rupture. For this, a systematic review of the literature was performed that included Cochrane, PubMed, and Embase. The following search terms were used: ankle fractures, syndesmosis rupture, tibiofibular syndesmosis injury, ankle joint, tightrope, and suture button. Inclusion criteria were comparison studies, acute ankle fractures with syndesmotic rupture, adult patients, and Coleman score >60. Cadaveric studies, chronic instability, open fractures, polytrauma, and arthropathies were exclusion criteria. Two investigators independently reviewed titles and relevant abstracts. Reoperation and malreduction rates were compared in a meta-analysis. Six studies with 275 patients were included: 2 randomized controlled trials and 2 prospective and 2 retrospective cohort studies. All studies used similar surgical techniques. Functional outcomes (American Orthopedic Foot and Ankle Society scale and the Olerud-Molander score) were not quantitatively comparable. No significantly less number of malreduction events were detected in the suture-button group (risk ratio = 0.19, 95% confidence interval 0.03 to 1.04, p = .06). Significantly lower reoperation rate was detected in the suture-button group (risk ratio = 0.21, 95% confidence interval 0.06 to 0.69, p = .01). We conclude that the suture-button technique showed a significantly lower reoperation rate and tendency toward less malreduction and better American Orthopedic Foot and Ankle Society scale scores. This finding is clinically relevant; however, this conclusion is primarily based on 2 studies, and therefore the interest for further research increases.