2021 Cardiac Surgery Annual Report

Morbidity Table 22 provides an outline of all complications and the incidence of each complication type for all RNSH isolated CABG surgery cases in 2021. Factors to note include: • Each case can have multiple complications and returns to theatre (RTT) in the postoperative period. • Each complication within the table has been counted as a separate incident.

Transfusion rate

The transfusion rate for on-pump and off-pump isolated CABG cases was calculated by dividing the number of transfusions by the number of on-pump and off-pump cases.

• For all isolated CABG cases, 63 (36.8%) patients were transfused • For on-pump isolated CABG cases, 50 (39.7%) patients were transfused • For off-pump isolated CABG cases, 13 (28.9%) patients were transfused

Complication

% of isolated CABG

n

On- or off-pump

Transfused

Transfusion rate (%)

n

Return to theatre (RTT) total

14

8.2

Re-op bleeding / tamponade

3

1.8

All

63

171

36.8

Re-op deep sternal wound infection

4

2.3

On-pump

50

126 39.7

Re-op insertion of pacemaker/AICD

2

1.2

Off-pump

13

45 28.9

Re-op other cardiac

2

1.2

Table 20. On- and off-pump comparisons for transfusion rate. Transfusion rate was calculated by dividing the number of transfused by the number of on- and off-pump cases (n).

Re-op other non-cardiac

4

2.3

New renal insufficiency

3

1.8

Post-operative indicators

Pre-/post-operative MI

2

1.2

Pre-/post-operative cardiogenic shock

3

1.8

Post-operative variables

Median (IQR)

Cardiac inotrope or vasopressor use

103

60.2

>4 hours post-operatively

102

59.6

Post-op ICU LOS (hours)

65.9 (47.1, 90.8)

for low cardiac output syndrome

35

20.5

Ventilation (hours)

8.4 (6, 13.3)

for low SVR syndrome

69

40.4

Blood loss (mls)

230 (150, 320)

New cardiac arrhythmia

45

26.3

Table 21. Post-operative indicators for all isolated CABG cases in ICU. Values are expressed as medians and interquartile ranges (IQR).

New neurologic

3

1.8

Stroke permanent

1

0.6

Blood loss

Stroke transient

1

0.6

Median blood loss within the first four hours post-operatively for all isolated CABG cases was 230 mls (IQR: 150, 320 mls).

Continuous coma ≥ 24hrs

1

0.6

Ventilation

New pulmonary

14

8.2

Median ventilation within the first four hours post-operatively for all isolated CABG cases was 8.4 hours (IQR: 6, 13.3 hours).

Ventilation prolonged (>24 hrs)

4

2.3

Pulmonary embolism

1

0.6

Post-operative ICU LOS

Pneumonia

9

5.3

Median post-operative LOS in ICU for all isolated CABG cases was 65.9 hours (IQR: 47.1, 90.8 hours).

Table 22. Complications observed in isolated CABG cases

34

35

Cardiac Surgery Annual Report 2021

Cardiac Surgery Annual Report 2021

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