Doppler Guided Intraoperative Fluid Management Data Analysis
- 1. 1 DOPPLER GUIDED INTRAOPERATIVE FLUID MANAGEMENT: DATA ANALYSIS NHS Technology Adoption Centre, January 2010.
- 2. Intervention vs. Comparator 2 Intervention (n = 626) London: 1st April 2008 – 30th April 2009; Manchester: 1st January 2009 – 30th November 2009; Derby: 19th September 2008 – 30th November 2009. Control (n = 621) London: 1st March 2007 – 31st March 2008; Manchester: 1st January 2008 – 30th December 2008; Derby: 1st March 2007 – 18th September 2008.
- 3. Surgical Procedures 3 Orthopaedics: Joint Replacement. Lower GI: Hartmann’s, Colectomy, Hemicolectomy. Upper GI: Whipples, Gastrostomy. Colorectal: Laparotomy, Bowel and Anterior Resection. Renal and Pancreas Transplants. Urological Cancer: Cystectomy and Nephrectomy.
- 4. Pre-operative Morbidity Risk 4 Assessment POSSUM: All Patients
- 5. 67% Decrease in Operative Mortality Rate 5
- 6. Intra-operative fluids administered: All 6 Patients
- 7. Length of Stay: All Patients 7
- 8. Post-operative Length of Stay: All 8 Patients
- 9. 23% Decrease in Central Venous 9 Catheter Insertion Rates
- 10. 33% Decrease in Re-admission Rate 10
- 11. 25% Decrease in Re-operation Rate 11
- 13. Critical Care Length of Stay 13 Level 1: Mean LOS – Intervention 3.11 Days, Control 2.95 Days. Median LOS – Intervention 3 Days, Control 3 Days. Level 2: Mean LOS – Intervention 4.58 Days, Control 4.73 Days. Median LOS – Intervention 3 Days, Control 3 Days. Level 3: Mean LOS – Intervention 8.40 Days, Control 19.31 Days. Median LOS – Intervention 6.5 Days, Control 11 Days.
- 14. Critical Care LOS: Level 1 14
- 15. Critical Care LOS: Level 2 15
- 16. Critical Care LOS: Level 3 16
- 17. Statistical significance 17 POSSUM score - Independent t-test Two-sided P = 0.020; Significant differences in POSSUM scores between the two groups. LOS and Post-op LOS - Independent t-test Two-sided P = 0.001 and P = 0.000 respectively; Significant differences in LOS and post-op LOS between the two groups. Note: If the p-value is <=0.05 the factor of interest is statistically different between the intervention and control (i.e. significant).
- 18. Statistical significance 18 CVC insertion - Independent t-test Two-sided P = 0.000; Significant differences in CVC insertion rate between the two groups. Re-admission and Re-operative rates – Independent t-test Two sided P = 0.286 and P = 0.212 respectively; No significant differences in re-admission and re-operative rates between the two groups.
- 19. Statistical significance 19 Mortality rate – Independent t-test Two-sided P = 0.001; Significant differences in mortality rates between the two groups. LOS in critical care levels 1,2 & 3 – Mann-Whitney test P = 0.265, P = 0.775 and P = 0.277 respectively; No significance differences observed in the length of stay for critical care levels 1,2 & 3 between the two groups.
- 20. Results Summary 20 67% Decrease in Mortality Three Day Reduction in Length of Stay Four Day Reduction in Post-op LOS 23% Decrease in CVC Insertion Rate 33% Decrease in Re-admission Rate 25% Decrease in Re-operation Rate Eleven Day Reduction in LOS within Critical Care Level Three