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An audit of out of hours interventional vascular radiology
S Surash1, I Robertson, T A J Calvey
1Department of Vascular Surgery, St James's University Hospital, Beckett Street, Leeds, LS9 7TF, U.K.
Background:
in 1996 the Royal College of Radiologists established a set of guidelines for out of hours radiology. Part of the recommendations determined that all units should regularly assess their own out of hours workload. In light of these guidelines we have audited our units interventional radiology activity.
Methods:
this was a retrospective study looking at the number of emergency angiograms and procedures performed over a 1-year period. Patients were identified from a vascular radiology database and case notes reviewed.
Results:
a total of 1902 patients had angiograms with 686 having further procedures. Of these, 1093 patients (57%) having 380 procedures (55%) were under the care of a consultant vascular surgeon. Of the vascular surgical patients only 17 patients (1.6%) were actually investigated out of hours (1700-0800 weekdays and at weekends). 5/17 (29%) patients received thrombolysis and 7/17 (41%) had either an angioplasty or stent. Despite being a major vascular unit only 2/17 (12%) were patients referred from outside the units own trust. Following diagnostic angiography, 13/17 (76%) of patients had an intervention performed within the first 24h.
Conclusion:
in a unit performing a large number of angiograms only a small number of patients require out of hours emergency angiography and interventional vascular procedures. Our impression is that this is the result of a flexible and responsive in hour's service. At the present time extra-hospital referrals do not appear to generate large amounts of out of hours work. This level of out of hours activity has implications in the provision of vascular radiological services in the future.
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