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Anaesthesia care team improves outcomes in surgical patients compared with solo anaesthesiologist

An observational study

Dony, Philippe; Seidel, Laurence; Pirson, Magali; Forget, Patrice

European Journal of Anaesthesiology (EJA): October 8, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/EJA.0000000000000891
ORIGINAL ARTICLE: PDF Only

BACKGROUND In anaesthesiology, little attention has been drawn to the role of anaesthesia nurses as support personnel on quality of care.

OBJECTIVES To compare the impact of anaesthesia by an anaesthesiologist alone (solo anaesthesiologist) or in combination with an anaesthesia nurse (anaesthesia care team) on 30-day postoperative mortality and hospital length of stay.

RESULTS Anaesthesia was performed by solo anaesthesiologists in 2832 patients and by an anaesthesia care team in 2842 patients. The two groups were comparable in respect of sex and duration of anaesthesia but differed notably for age, American Society of Anesthesiologists’ physical status score and type of surgery. Propensity score matching was performed by logistic regression to adjust for baseline differences between the two groups and 2095 pairs of perfectly matched patients were formed. The latter evidenced a significantly lower 30-day mortality rate for the anaesthesia care team compared with solo anaesthesiologists (0.76 vs. 1.56%, P = 0.0014). Length of hospital stay was also significantly reduced when an anaesthesia nurse was present (4.9 ± 10.1 vs. 5.6 ± 11.5 days, P = 0.0011).

CONCLUSION Anaesthesia given by the combination of an anaesthesiologist and an anaesthesia nurse is associated with decreased 30-day postoperative mortality and shorter length of stay when compared with a solo anaesthesiologist. Even if without any demonstration of causality, this emphasises the benefits of the anaesthesia care team model.

TRIAL REGISTRATION CCB 325201730849.

Department of Biostatistics, University Hospital of Liège, Liège (LS), Health Economics, Health Facility Administration and Nursing Science, Ecole de Santé publique, Université Libre de Bruxelles (PD, MP) and Anaesthesiology and Perioperative Medicine, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium (PF)

Correspondence to Patrice Forget, Anaesthesiology and Perioperative Medicine, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium Tel: +32 24773058; e-mail: forgetpatrice@yahoo.fr

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© 2018 European Society of Anaesthesiology