Evolution of anaesthesia practice, demography and complications in Switzerland: results of a 15-years routine data collection

TitreEvolution of anaesthesia practice, demography and complications in Switzerland: results of a 15-years routine data collection
Publication TypeConference Paper
Year of Publication2012
AuthorsPittet, V, Perret, C, Moret, V, Burnand, B, ADS study Group
Conference Name60 Jahre Schweizerische Gesellschaft für Anästhesiologie und Reanimation SGAR und 40 Jahre Schweizerische Gesellschaft für Intensivmedizin SGI
Date Published2012
PublisherSchweiz Med Forum 2012;12(Suppl. 59) 33 S
Conference LocationBasel, 15.–17. November 2012
Abstract

Background: Quality and safety in anaesthesiology request continuous monitoring. Currently, anaesthesia is used more often in older, high risk patients. Anaesthesia Database Switzerland (ADS) is a data registry implemented in almost 25% of all Swiss hospitals. Its main goal is to foster quality improvement by providing anaesthesia departments with benchmark comparisons and incidents analysis. We present the evolution of the anaesthetic practice in Switzerland for 1996–2010.

Methods: ADS includes three modules: 1) “Minimal data set” includes basic anaesthesia- (type, chronology, operations, emergency) and patient variables (age, gender, ASA index); 2) “Management and techniques” gathers variables on operating rooms, supervisors, anaesthesia techniques; 3) “Quality” gathers variables on per-/ post-anaesthesia incidents and their severity, and patients’ comorbidities. Each hospital is responsible for its data collection and control. Anonymous data extracts are regularly sent to a data centre for validation and analyses purposes.  

Results: In 2010, 37 hospitals were participating in at least one module and 21 were collecting data related to quality. Since 1996, a total of 2’158’735 anaesthetic procedures have been included in the central database. Among the 1’739’794 documented procedures related to surgery, 63% were general, 29% loco-regional and 8% combined anaesthesia; about 19% of cases were emergencies. Among patients receiving surgical anaesthesia, 53% were women, and mean age (SD) was 48 (23). A linear increase in the percentage of patients‘ age was observed over time > 50, with a maximum in the 50–64 category (coefficient (c) = 0.49; p <0.001). Overall, 80% of patients had an ASA score of 1 or 2; a linear decrease in the percentage of ASA 1 was observed over time (c = –1.25; p <0.001) and an increase of ASA 2 (c = 0.842; p <0.001) or ASA 3 (c = 0.33; p <0.001). The prominent comorbidities were hypertension (21%), allergy (15%), smoking (16%) and obesity (12%). A total of 154’036 incidents were recorded between 1996 and 2010, among the 15% of all anaesthesia with a recorded complication: 30% were cardiovascular, 6% respiratory, 32% specific to anaesthesia and 18% general.

Conclusion: Trends in anaesthesia healthcare observed in Switzerland over the last 15 years are: ageing of population receiving surgical anaesthesia and an increase in the severity of pathologies. ADS enable hospitals to monitor their own activity and allows benchmarking among participants.

Notes

Poster P43

URLhttp://medicalforum.ch/fileadmin/redakteur/docs/smf/archiv/de/2012/suppl_59.pdf
Citation Key / SERVAL ID6574

                         

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