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7. Clinical risk management
Profile of operative procedures
7.1.
The following section examines the frequency and timing of surgical procedures, the seniority of the surgeon
performing them, and the need for reoperation.
The role of the treating surgeon is to take responsibility for the overall success of the operation; they need to ensure
that the operation proceeds smoothly and with the lowest possible risk of complications or an unplanned return to
theatre.
Figure 10: Frequency of individual surgical procedures
Note: total n=5,184 patients having operative treatment (with 7,270 episodes).
Audit period 1 July 2007 to 30 June 2015.
Only procedures with a frequency >10 interventions have been recorded.
AAA: abdominal aortic aneurysm; GI: gastrointestinal; ENT: Ear, nose and throat.
The operative procedures were categorised in this annual report to group the operations for simpler classification. A breakdown of operative
procedures is detailed in the 2015 VASM Technical Report.
Comments:
•
There were 5,184 patients who underwent operative treatment (2007-2015). As a patient can undergo multiple
procedures during the same admission, and at the same surgical session, 7,270 separate procedures were
performed in total.
•
During the last sequential year of the audit period 2014-2015 there was a 4.1% increase in the number of
patients that had multiple surgical episodes. This increase has not reach statistical significance
p=0.8
. (data
now shown)
•
The most frequent procedures reported have usually been associated with laparotomy, laparoscopy and
upper gastrointestinal (the most usual group of multiple procedures), and orthopaedic pathologies.
1,677
847
609
608
581
448
414
386
366
332
215
166
92
79
75
25
21
0%
10%
20%
30%
Laparotomy(-oscopy) and upper GI
Orthopaedic
Colorectal
Wound care
Cardiac
Neurosurgical trauma
Neurosurgical non-trauma
Other abdominal and hernia
GI Endoscopy
Thoracic and tracheostomy
Peripheral vascular
Urology
Amputations
Hepatobiliary
Ruptured AAA
Head and neck including ENT
Gynaecology
Operations (%)
Operative procedure
21.1%
>1 procedure per patient
2007-2014
25.2%
>1 procedure per patient
2014-2015