Title |
Patient characteristics, anaesthetic workload and techniques in the UK: an analysis from the 7th National Audit Project (NAP7) activity survey
|
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Published in |
Anaesthesia, March 2023
|
DOI | 10.1111/anae.15989 |
Pubmed ID | |
Authors |
A. D. Kane, J. Soar, R. A. Armstrong, E. Kursumovic, M. T. Davies, F. C. Oglesby, L. Cortes, C. Taylor, I. K. Moppett, S. Agarwal, J. Cordingley, J. Dorey, S. J. Finney, G. Kunst, D. N. Lucas, G. Nickols, R. Mouton, J. P. Nolan, B. Patel, V. J. Pappachan, F. Plaat, B. R. Scholefield, J. H. Smith, L. Varney, T. M. Cook, collaborators |
Abstract |
Detailed contemporary knowledge of the characteristics of the surgical population, national anaesthetic workload, anaesthetic techniques and behaviours are essential to monitor productivity, inform policy and direct research themes. Every 3-4 years, the Royal College of Anaesthetists, as part of its National Audit Projects (NAP), performs a snapshot activity survey in all UK hospitals delivering anaesthesia, collecting patient-level encounter data from all cases under the care of an anaesthetist. During November 2021, as part of NAP7, anaesthetists recorded details of all cases undertaken over 4 days at their site through an online survey capturing anonymous patient characteristics and anaesthetic details. Of 416 hospital sites invited to participate, 352 (85%) completed the activity survey. From these, 24,177 reports were returned, of which 24,172 (99%) were included in the final dataset. The work patterns by day of the week, time of day and surgical specialty were similar to previous NAP activity surveys. However, in non-obstetric patients, between NAP5 (2013) and NAP7 (2021) activity surveys, the estimated median age of patients increased by 2.3 years from median (IQR) of 50.5 (28.4-69.1) to 52.8 (32.1-69.2) years. The median (IQR) BMI increased from 24.9 (21.5-29.5) to 26.7 (22.3-31.7) kg.m-2 . The proportion of patients who scored as ASA physical status 1 decreased from 37% in NAP5 to 24% in NAP7. The use of total intravenous anaesthesia increased from 8% of general anaesthesia cases to 26% between NAP5 and NAP7. Some changes may reflect the impact of the COVID-19 pandemic on the anaesthetic population, though patients with confirmed COVID-19 accounted for only 149 (1%) cases. These data show a rising burden of age, obesity and comorbidity in patients requiring anaesthesia care, likely to impact UK peri-operative services significantly. |
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Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 50 | 21% |
Australia | 4 | 2% |
Ireland | 2 | <1% |
United States | 2 | <1% |
Japan | 1 | <1% |
Comoros | 1 | <1% |
Switzerland | 1 | <1% |
Canada | 1 | <1% |
Nigeria | 1 | <1% |
Other | 3 | 1% |
Unknown | 170 | 72% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 179 | 76% |
Practitioners (doctors, other healthcare professionals) | 31 | 13% |
Scientists | 14 | 6% |
Science communicators (journalists, bloggers, editors) | 11 | 5% |
Unknown | 1 | <1% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 31 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 5 | 16% |
Other | 3 | 10% |
Lecturer | 1 | 3% |
Lecturer > Senior Lecturer | 1 | 3% |
Student > Master | 1 | 3% |
Other | 3 | 10% |
Unknown | 17 | 55% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 10 | 32% |
Agricultural and Biological Sciences | 1 | 3% |
Arts and Humanities | 1 | 3% |
Psychology | 1 | 3% |
Computer Science | 1 | 3% |
Other | 0 | 0% |
Unknown | 17 | 55% |