title: Prospective audit of vascular surgical emergencies in a district general hospital.
abstract: A prospective clinical audit was carried out to assess the volume and distribution of workload generated by vascular surgical emergencies over a 3-month period in a single health district in the UK. Of 53 consecutive patients referred as surgical emergencies with peripheral vascular problems, 45 were referred to a single vascular surgeon, 36 directly from a general practitioner or other specialist and nine from another general surgeon. A total of 39 operations and six radiological procedures were carried out, including 26 vascular reconstructions. To accommodate the 27 non-urgent operations, nine were performed 'out of hours' and 17 planned cases were cancelled. A median of five general surgical beds were required throughout the period studied and 11 patients required intensive therapy unit admission for a total of 39 days. It is concluded that vascular surgical emergencies constitute a substantial workload and are being dealt with mainly by a single vascular surgeon who effectively works a one in one rota. Inadequate facilities for urgent vascular surgery lead to a large number of cases being dealt with out of hours and frequent cancellation of routine operations.
authors.affiliation: Royal Berkshire Hospital, Reading, UK.
authors.forename: J A
authors.initials: JA
authors.lastname: Michaels
authors.forename: R B
authors.initials: RB
authors.lastname: Galland
mesh_terms: D004630:Emergencies; D004739:England; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006767:Hospitals, District / Q000706:statistics & numerical data*; D006769:Hospitals, General / Q000706:statistics & numerical data*; D006801:Humans; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data*; D014600:Utilization Review; D014652:Vascular Diseases / Q000601:surgery; D014656:Vascular Surgical Procedures / Q000592:standards* / Q000706:statistics & numerical data; D016526:Workload