The Barbados AIDS audit: patient contact with surgical services and accident and emergency - abstract

ABSTRACT

The records of 653 adult HIV-positive patients, covering the period July 1984 to June 1995, were reviewed to determine patient contact with surgical services at the Queen Elizabeth Hospital (QEH). The relationship of the Accident & Emergency (A&E) attendance prior to admission and survival was also assessed for first respiratory admissions. The balance of care between the HIV clinic at the QEH and the A&E department was also assessed. Surgical outpatient contact chiefly comprised consultations for ano-genital warts and follow appointment after admissions. There were 50 admissions (5 deaths) on the surgical wards out of a total of 1059 admissions. Ischiorectal abcesses were the cause of eight admissions and five patients were admitted after a fight; other admissions were for a wide range of reasons. Eight patients had a lymph node biopsy (4 whilst on medical wards) reflecting the conservative approach to lymphadenopathy in Barbados. Admission from the A&E was the most frequent route of admission associated with a worse outcome. There was no trend to decrease involvement in ambulatory care by A&E over time. In conclusion, the audit has shown that the A&E Department must be a focus for improving care. (AU)