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.

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.

Citation

Walker, E., Bell, M., Cook, T., Grocott, M., & Moonesinghe, S. (2016). Patient reported outcome of adult perioperative anaesthesia in the United Kingdom: a cross-sectional observational study. British Journal of Anaesthesia, 117(6), 758-766r. https://doi.org/10.1093/bja/aew381

• 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