title: Patient reported outcome of adult perioperative anaesthesia in the United Kingdom: a cross-sectional observational study.
abstract: 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.
  
  
  
  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.
  
  
  
  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%)
  
  
  
  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.
authors.affiliation: National Institute of Academic Anaesthesia Health Services Research Centre, Royal College of Anaesthetists, London, WC1R 4SG, UK.
authors.forename: E M K
authors.initials: EMK
authors.lastname: Walker
authors.affiliation: Royal College of Anaesthetists, London, WC1R 4SG, UK.
authors.forename: M
authors.initials: M
authors.lastname: Bell
authors.affiliation: Royal United Hospital NHS Foundation Trust Bath, BA1 3NG, UK.
authors.forename: T M
authors.initials: TM
authors.lastname: Cook
authors.affiliation: Faculty of Medicine, University of Southampton, Southampton, SO17 1BJ, UK.
authors.forename: M P W
authors.initials: MPW
authors.lastname: Grocott
authors.affiliation: National Institute of Academic Anaesthesia Health Services Research Centre, Royal College of Anaesthetists, London, WC1R 4SG, UK, and UCL/UCLH Surgical Outcomes Research Centre, Department of Anaesthetics and UCL Centre for Anaesthesia, University College Hospital, London, NW1 2BU, UK.
authors.forename: S R
authors.initials: SR
authors.lastname: Moonesinghe
mesh_terms: D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000009:adverse effects; D000765:Anesthesia, Conduction; D001007:Anxiety / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D058926:Intraoperative Awareness / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D017060:Patient Satisfaction; D019990:Perioperative Care / Q000379:methods*; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
keywords:  anaesthesia; awareness; health care; outcome; patient satisfaction; quality indicators