The anaesthetist >> Membership of the VASGBI

VASGBI Membership Outcome

VASGBI Membership

The anaesthetist was a member of the Vascular Anaesthesia Society of Great Britain and Ireland in 52% of elective admission cases and 26% of emergency admission cases.

Table 9 gives the number of anaesthetics for open operations when the most senior anaesthetist present was a member of the VASGBI.

Table 9. Proportion of anaesthetics given by whether anaesthetist was a member of VASGBI
Member of VASGBI Elective operation % Emergency operation % Not answered Total %
Yes 187 52 54 26 19 260 42
No 170 48 153 74 32 355 58
Sub-total 357   207   51 615  
Unknown 20   12   1 33  
Not answered 57   45   2 104  
Total 434   264   54 752  


The objectives of the VASGBI are: “To promote the highest standard of management and care for patients suffering from cardiovascular disorders, and in particular those undergoing vascular surgery, and to further the development of the art and science of vascular anaesthesia” 6. The Society runs educational meetings, awards travelling fellowships and research grants, and collects audit data on vascular anaesthesia. The advisors discussed whether membership of the VASGBI could be viewed as a surrogate for the competence of the anaesthetist at vascular surgery. It is important to recognise that the Society is open both to those who are actively involved in vascular anaesthesia on a regular basis and to those who wish to remain up to date but only have an occasional exposure to vascular cases. Membership is entirely optional, and highly competent vascular anaesthetists may not wish to join, for a variety of reasons.
The anaesthetist was more likely to be a member of the VASGBI for elective operations, when the anaesthetist would probably cover the list regularly, than for emergency operations when the anaesthetist would be drawn from the whole of the on-call rota.

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Outcome

There was no difference in the outcome of elective surgery associated with whether the anaesthetist was a member of the VASGBI or not. (Table 10).

Table 10. Anaesthetist’s membership of the VASGBI by outcome of elective open repairs
Member of VASGBI Died within 30 days % died within 30 days Alive at 30 days Not answered Total
Yes 12 6 174 1 187
No 12 7 158 0 170
Sub-total 24   332 1 357
Unknown 1   19 0 20
Not answered 2   54 1 57
Total 27   405 2 434

There was no difference in the outcome of emergency open operations for unruptured aneurysms (Table 11). However, there was a difference in the outcome of emergency open operations for ruptured aneurysms (Table 12).

Table 11. Anaesthetist’s membership of the VASGBI by outcome of emergency open repairs for unruptured aneurysms
Member of VASGBI Died within 30 days % died within 30 days Alive at 30 days Total
Yes 5 16 26 31
No 6 14 37 43
Sub-total 11   63 74
Unknown 0   1 1
Not answered 7   4 11
Total 18   68 86

Table 12. Anaesthetist’s membership of the VASGBI by outcome of emergency open repairs for ruptured aneurysms
Member of VASGBI Died within 30 days % died within 30 days Alive at 30 days Total
Yes 6 26 17 23
No 47 46 55 102
Sub-total 53   72 125
Unknown 5   6 11
Not answered 14   18 32

Total

72   96 168

There was a better outcome for open repair of ruptured aortic aneurysm associated with the presence of an anaesthetist who was a member of the VASGBI. The numbers are very small and data were missing in 26% of cases, so this finding should be treated with caution. Is this finding genuine? If so, is membership of the VASGBI by the anaesthetist only a marker of other differences in service provision?

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