Postoperative patient complaints: a prospective interview study of 12,276 patients

Lehmann, Michael; Monte, Kai; Barach, Paul; Kindler, Christoph H.

doi:10.1016/j.jclinane.2009.02.015

« Previous Next »Journal of Clinical Anesthesia
Volume 22, Issue 1 , Pages 13-21, February 2010

Postoperative patient complaints: a prospective interview study of 12,276 patients☆

Michael Lehmann, MD (Resident in Anesthesia)
- Department of Anesthesia, University Hospital Basel, CH-4031 Basel, Switzerland
Kai Monte, CRNA (Certified Registered Nurse Anesthetist)
- Department of Anesthesia, University Hospital Basel, CH-4031 Basel, Switzerland
Paul Barach, MD, MPH (Associate Professor)
- Department of Anesthesiology, Medicine and Epidemiology, University of South Florida College of Medicine, Tampa, FL 33612, USA
- Utrecht University Medical Center, 3508 GA Utrecht, The Netherlands
Christoph H. Kindler, MD (Professor)
- Department of Anesthesia and Perioperative Medicine, Kantonsspital Aarau, CH-5001 Aarau, Switzerland
- Corresponding author. Christoph H. Kindler, MD, Professor and Chairman, Department of Anesthesia and Perioperative Medicine, Kantonsspital Aarau AG, CH-5001 Aarau, Switzerland. Tel.: +41 62 838 4581; fax: +41 62 838 6722.

Received 16 November 2007; received in revised form 5 February 2009; accepted 11 February 2009.

Abstract

Study Objective

To evaluate the incidence of perioperative minor adverse events and to analyze patient satisfaction based on potential explanatory variables.

Design

Structured, face-to-face interview of 25% of all patients undergoing surgery during the period from January 2003 through June 2006.

Setting

Academic university medical center.

Patients

12,276 patients (5,793 men and 6,483 women) from all surgical disciplines: 7,440 patients had general anesthesia, 4,236 patients had regional anesthesia, and 600 patients had a combined general-regional anesthetic technique.

Measurements

Occurrence of perioperative minor adverse events was assessed during the interview. Patient satisfaction was measured with a 4-point Likert scale.

Main Results

3,652 (30%) patients reported at least one perioperative complaint and 737 (6%) patients reported multiple minor adverse events. Overall, a total of 4,475 minor adverse events were reported. Leading adverse events included postoperative nausea and vomiting (1,705 complaints), sore throat (1,228 complaints), and hoarseness (802 complaints). Patient satisfaction with anesthetic care was generally high (97% satisfied or highly satisfied). Patients were significantly more satisfied following regional than general anesthesia (P < 0.001). Patient dissatisfaction was also associated with the occurrence of at least one minor adverse event (P < 0.001) or with increasing ASA physical status (P < 0.001).

Conclusion

Minor events occur with a surprisingly high incidence and are significantly associated with patient dissatisfaction. Regional anesthesia is associated with fewer patient complaints and significantly higher postoperative patient satisfaction.

Keywords: Adverse events, Complications, Patient complaints, Patient safety, Quality improvement, Taxonomy