Page 16 - ANZCP Gazette May 2023 TEASER

impact of quality improvements, changes in practise and measure future trends. It will also allow for benchmarking between sites and quality analysis for smaller patient subpopulations or for specific procedure types. With nine participating sites, DAH30 data will grow quickly and become a useful measure of perfusion quality for all sorts of future projects.
Most importantly and excitingly, using this new sensitive outcome measure, we plan to investigate what perfusion f a c t o r s i m p a c t a p a t i e n t s DA H 3 0 . W h a t m o d i fi a b l e intraoperative factors impact our patient's recovery? What can we do as perfusionists to improve our patients journey home? This next phase for the project will identify which perfusion factors we can focus on to improve and maximise the DAH30 for our patients.
Could DAH30 be the ‘Holy Grail’ of perfusion quality? Could it provide definitive evidence to guide our pump run improving patient outcomes? Could it identify what really matters on bypass? Is it flow, or is it pressure, or is it both that impacts DAH30 and improves the patient recovery to home? Is it venous saturations or DO2 that makes a difference? Or perhaps is it anaemia or transfusion on bypass that impacts patients more? This next phase of the project is already underway.
With special thanks to Prof Paul Myles
Prof Paul Myles initially suggested investigating DAH30 for the Australian cardiac surgical patients and has been kind to answer my queries. This project was undertaken to assess the feasibility of collecting DAH30 as a pilot for the ANZCPR collaborative. Prof Myles has published widely on DAH30. He even has an animated video online outlining its virtues. Click here to view these articles DAH 30 - Department of Anaesthesiology and Perioperative Medicine (periopmedicine.net) https:// www.periopmedicine.net/dah-30
References:
1. Myles PS, Shulman MA, Heritier S, et al. Validation of days at home as an outcome measure after surgery: a prospective cohort study in Australia. BMJ Open 2017;7:e015828. doi: 10.1136/bmjopen-2017-015828
2. Bell M, Eriksson LI, Svensson T, Hallqvist L, Granath F, Reilly J, Myles PS. Days at home after surgery: an integrated and efficient outcome measure for clinical trials and quality assurance. EClinicalMedicine. 2019 May 1;11:18-26.
3. Angela Jerath, Peter C. Austin, Duminda N. Wijeysundera; Days Alive and Out of Hospital: Validation of a Patient-centered Outcome for Perioperative Medicine. A n e s t h e s i o l o g y 2 0 1 9 ; 1 3 1 : 8 4 – 9 3 d o i : h t t p s : // d o i . org/10.1097/ALN.0000000000002701
4. Jerath A, Austin PC, Ko DT, Wijeysundera HC, Fremes S, McCormack D, Wijeysundera DN. Socioeconomic Status and Days Alive and Out of Hospital after Major Elective Noncardiac Surgery: A Population-based Cohort Study. Anesthesiology. 2020 Apr;132(4):713-722. doi: 10.1097/ ALN.0000000000003123. PMID: 31972656.
5. Ariti CA, Cleland JG, Pocock SJ, Pfeffer MA, Swedberg K, Granger CB, McMurray JJ, Michelson EL, Ostergren J, Yusuf S. Days alive and out of hospital and the patient journey in patients with heart failure: Insights from the candesartan in heart failure: assessment of reduction in mortality and morbidity (CHARM) program. Am Heart J. 2011 Nov;162(5):900-6. doi: 10.1016/j.ahj.2011.08.003. Epub 2011 Oct 7. PMID: 22093207.
6. Hospital costs and factors associated with days alive and at home after surgery (DAH30). Jennifer R Reilly, Paul S Myles, Darren Wong, Stephane R Heritier, Wendy A Brown, Toby Richards and Max Bell Med J Aust 2022; 217 (6): 311-317. || doi: 10.5694/mja2.51658
7. Angela Jerath, Peter C. Austin, Duminda N. Wijeysundera; Days Alive and Out of Hospital: Validation of a Patient-centered Outcome for Perioperative Medicine. A n e s t h e s i o l o g y 2 0 1 9 ; 1 3 1 : 8 4 – 9 3 d o i : h t t p s : // d o i . org/10.1097/ALN.0000000000002701
13 MAY 2023 | www.anzcp.org