A multicentre study of the trend of adverse events during outpatient anaesthesia in Switzerland during 2000-2016.

BACKGROUND: Over the last three decades, the use of outpatient surgery has been steadily increasing. Simultaneously, there has been an inciting movement to measure and improve healthcare quality and safety. Nevertheless, anaesthesia-related morbidity remains significant. We aimed to evaluate the incidence of intraoperative adverse events (IAEs) occurring during outpatient surgery. METHODS: We used data from the Anaesthesia Databank Switzerland (ADS), a voluntary register. We assessed the overall and specific incidence of IAEs, according to a predefined list of technical, cardiovascular, organisational, respiratory, and general incidents in Switzerland between 2000 and 2016. Primary and secondary outcomes were modelled using multi-level logistic regression analysis, and the time trend on the probabilities of events was assessed. RESULTS: Between 2000 and 2016, 289,948 outpatient anaesthesia procedures were performed. During this period, the estimated probability of overall intraoperative adverse events decreased from 10.8% to 6.3%, and from 2.3% to 1.4% for technical incidents, from 3.0% to 2.2% for cardiovascular, from 1.6% to 1.3% for organisational, from 0.9% to 0.7% for general, and from 1.1% to 0.7% for respiratory incidents. CONCLUSIONS: The occurrence of intraoperative adverse events in ambulatory anaesthesia has continuously decreased between 2000 and 2016. This trend is essentially attributable to a reduction in the incidence of technical, cardiovascular and organisational events.  .

PFAPA syndrome is not a sporadic disease.

OBJECTIVES: To determine whether PFAPA (periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis) patients have a positive family history (FH) for recurrent fever syndromes. METHOD: For all patients with PFAPA seen in two paediatric rheumatology centres (Romandy, Switzerland and Bordeaux, France), parents were interviewed to record the FH for periodic fever. As controls, we interviewed a group of children without history of recurrent fever. RESULTS: We recruited 84 patients with PFAPA and 47 healthy children. The FH for recurrent fever (without an infectious cause and recurring for at least half a year) was positive in 38/84 (45%), and was positive for PFAPA (diagnosis confirmed by a physician) in 10/84 (12%) of the PFAPA patients. For 29 of the 38 patients with positive FH, the affected person was a sibling or a parent. None of the healthy children had a positive FH for recurrent fever or PFAPA. A positive FH for rheumatological diseases was seen in both groups of children. CONCLUSION: These data show that a significant percentage of PFAPA patients present a positive FH of recurrent fever and PFAPA. This familial susceptibility suggests a potential genetic origin for this syndrome.