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Patient reported outcome of adult perioperative anaesthesia in the United Kingdom: a cross-sectional observational study

Walker, E.M.K.; Bell, M.; Cook, T.M.; Grocott, M.P.W.; Moonesinghe, S.R.

Authors

E.M.K. Walker

M. Bell

T.M. Cook

M.P.W. Grocott

S.R. Moonesinghe



Abstract

Background. Understanding the patient perspective on healthcare is central to the evaluation of quality. This study measured selected patient-reported outcomes after anaesthesia in order to identify targets for research and quality improvement.

Methods. This cross-sectional observational study in UK National Health Service hospitals, recruited adults undergoing non-obstetric surgery requiring anaesthesia care over a 48?h period. Within 24?h of surgery, patients completed the Bauer questionnaire (measuring postoperative discomfort and satisfaction with anaesthesia care), and a modified Brice questionnaire to elicit symptoms suggestive of accidental awareness during general anaesthesia (AAGA). Patient, procedural and pharmacological data were recorded to enable exploration of risk factors for these poor outcomes.

Results. 257 hospitals in 171 NHS Trusts participated (97% of eligible organisations). Baseline characteristics were collected on 16,222 patients; 15,040 (93%) completed postoperative questionnaires. Anxiety was most frequently cited as the worst aspect of the perioperative experience. Thirty-five per cent of patients reported severe discomfort in at least one domain: thirst (18.5%; 95% CI 17.8-19.1), surgical pain (11.0%; 10.5-11.5) and drowsiness (10.1%; 9.6-10.5) were most common. Despite this, only 5% reported dissatisfaction with any aspect of anaesthesia-related care. Regional anaesthesia was associated with a reduced burden of side-effects. The incidence of reported AAGA was one in 800 general anaesthetics (0.12%)

Conclusions. Anxiety and discomfort after surgery are common; despite this, satisfaction with anaesthesia care in the UK is high. The inconsistent relationship between patient-reported outcome, patient experience and patient satisfaction supports using all three of these domains to provide a comprehensive assessment of the quality of anaesthesia care.

Journal Article Type Article
Acceptance Date Oct 21, 2016
Online Publication Date Dec 13, 2017
Publication Date 2016-12
Deposit Date Aug 1, 2017
Journal British Journal of Anaesthesia
Print ISSN 0007-0912
Electronic ISSN 1471-6771
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 117
Issue 6
Pages 758-766r
DOI https://doi.org/10.1093/bja/aew381
Keywords anaesthesia, awareness, health care, outcome, patient satisfaction, quality indicators
Public URL https://nottingham-repository.worktribe.com/output/835707
Publisher URL https://academic.oup.com/bja/article-lookup/doi/10.1093/bja/aew381


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