Page 15 - ANZCP Gazette May 2023

Table 2: Pre-Op Risk Factors Variable N
Smoking
Non- smoker 589 History of smoking 430 Current smoker 90 Diabetes
No 766
Raw Median Iqr p DAH30 DAH30
Table 3: Post op Complications
0.49
<0.01 <0.01 <0.01
<0.01 <0.01
<0.01
<0.01
<0.01
p
<0.01
Variable
Any new Infection
No
Yes
4-hr blood loss (ml)
< 500
501 - 1000 > 1000
New Renal Failure (NRF)
No
Yes
New Post Op Arrhythmia
No
Yes
New Permanent stroke
No
Yes
New transient stroke
No
Yes
New Pneumonia
N Raw Median Iqr DAH30 DAH30
1295 21 9 37 7 13
<0.01
<0.01
Yes
Pre-Op heart failure
No
Yes
Pre-Op Creatinine
Normal High
Critical High
Dialysis
No
Yes
Pre-Op Hb
Normal
Low
Pre-Op Cerebrovascular Disease
No
Yes
Pre-Op Peripheral Vascular Disease
No
Yes
Pre-Op Infective Endocarditis
No
Yes
Previous MI
Unknown No NSTEMI STEMI
Angina Class
0 1 2 3 4
Pre-Op Arrhythmia
No
Yes
Pre-Op EF
Normal
Mild Impairment Moderate Severe
Pre-Op eGFR
Normal Low
21 9 566 20 11
1103 22 8 169 17 15 56 16.5 18
21 9 21 9 21 8
1143 21 8 189 16 17
858 22 8 429 19 14 45 15 16
1288 21 9.5 44 15 15
958 22 7 374 17 18
1205 21 9 127 15 21
1242 21 9 90 16 18
1280 21 9 52 2.5 16.5
1282 219 47 5 14
0.63 28 21 23.5
756 21 10 445 22 9 103 21 8
585 20 12 143 22 8 321 21 7 200 22 9
83 21 11
1134 22 9 198 17 14
528 21 9 536 22 8.5 181 19 13 64 16.5 21
691 22 7 641 19 12
<0.01
<0.01 <0.01
<0.01
<0.01 331 17 15
998 228
1284 219 45 0 3
<0.01
<0.01
1321 21 10 8 129
<0.01 88 4.5 15
Also unsurprisingly, post-operative complications have significant observed differences in DAH30 (Table
3), some by many days like infection and NRF. The
raw DAH30 values for these groups are displayed graphically in Figure 5 where the difference is evident. The red bars are the DAH30 for patients with no post-op complications, while the orange bars represent the DAH30 for patients experiencing any complication listed in Table 3. It’s noteworthy how many patients with a post-op complication are still in a healthcare facility 30 days after their surgery and have not been home at all. Minimising post-op complications will improve a patient's recovery to home. These zero DAH30 values may not be accurately reflected in the poLOS values as many of these patients are transferred to a secondary hospital/ rehab after discharge from Westmead hospital. This allows the patient to take time to recover while freeing beds for the primary hospital to continue performing surgery. Comparison of DAH30 with poLOS is the subject of further analysis and will be published at a later date.
As mentioned, I am looking forward to sharing this data once we have performed the bespoke statistical regression model which will identify which factors are most associated with DAH30.
The future for this DAH30 project
As a result of this favourable feasibility study, DAH30 is now to be included in ANZCPR perfusion registry dataset. This will enable participating sites to measure the
No 1241218 Yes
MAY 2023 | www.anzcp.org 12