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Article: The incidence and effect of resternotomy following cardiac surgery on morbidity and mortality: a 1‐year national audit on behalf of the Association of Cardiothoracic Anaesthesia and Critical Care

TitleThe incidence and effect of resternotomy following cardiac surgery on morbidity and mortality: a 1‐year national audit on behalf of the Association of Cardiothoracic Anaesthesia and Critical Care
Authors
Keywordscardiac arrest
cardiac surgery
haemorrhage
resternotomy
Issue Date2021
PublisherWiley-Blackwell Publishing Ltd. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2044
Citation
Anaesthesia, 2021, v. 76 n. 1, p. 19-26 How to Cite?
AbstractOver 30,000 adult cardiac operations are carried out in the UK annually. A small number of these patients need to return to theatre in the first few days after the initial surgery, but the exact proportion is unknown. The majority of these resternotomies are for bleeding or cardiac tamponade. The Association of Cardiothoracic Anaesthesia and Critical Care carried out a 1‐year national audit of resternotomy in 2018. Twenty‐three of the 35 centres that were eligible participated. The overall resternotomy rate (95%CI) within the period of admission for the initial operation in these centres was 3.6% (3.37–3.85). The rate varied between centres from 0.69% to 7.6%. Of the 849 patients who required resternotomy, 127 subsequently died, giving a mortality rate (95%CI) of 15.0% (12.7–17.5). In patients who underwent resternotomy, the median (IQR [range]) length of stay on ICU was 5 (2–10 [0–335]) days, and time to tracheal extubation was 20 (12–48 [0–2880]) hours. A total of 89.3% of patients who underwent resternotomy were transfused red cells, with a median (IQR [range]) of 4 (2–7 [1–1144]) units of red blood cells. The rate (95%CI) of needing renal replacement therapy was 23.4% (20.6–26.5). This UK‐wide audit has demonstrated that resternotomy after cardiac surgery is associated with prolonged intensive care stay, high rates of blood transfusion, renal replacement therapy and very high mortality. Further research into this area is required to try to improve patient care and outcomes in patients who require resternotomy in the first 24 h after cardiac surgery.
Persistent Identifierhttp://hdl.handle.net/10722/289320
ISSN
2023 Impact Factor: 7.5
2023 SCImago Journal Rankings: 2.400
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorAgarwal, S-
dc.contributor.authorChoi, SW-
dc.contributor.authorFletcher, SN-
dc.contributor.authorKlein, A-
dc.contributor.authorGill, R-
dc.contributor.authorAnderson, L-
dc.contributor.authorAl‐Azzawi, O-
dc.contributor.authorArenas, E-
dc.contributor.authorBill, KM-
dc.contributor.authorBurns, H-
dc.contributor.authorChawla, A-
dc.contributor.authorElder, R-
dc.contributor.authorFogg, K-
dc.contributor.authorGambino, G-
dc.contributor.authorGarcia, C-
dc.contributor.authorGiminez, M-
dc.contributor.authorHayes, T-
dc.contributor.authorHodek, A-
dc.contributor.authorMellor, A-
dc.contributor.authorMikhail, C-
dc.contributor.authorMorrice, D-
dc.contributor.authorO'Connor, C-
dc.contributor.authorPlace, D-
dc.contributor.authorRiley, E-
dc.contributor.authorSandys, S-
dc.contributor.authorShaban, I-
dc.contributor.authorShaw, M-
dc.contributor.authorShepherd, S-
dc.contributor.authorSingh, H-
dc.contributor.authorKadayam Sreenivasan, R-
dc.contributor.authorSubramanian, R-
dc.contributor.authorWalker, C-
dc.contributor.authorWoodward, D-
dc.date.accessioned2020-10-22T08:10:59Z-
dc.date.available2020-10-22T08:10:59Z-
dc.date.issued2021-
dc.identifier.citationAnaesthesia, 2021, v. 76 n. 1, p. 19-26-
dc.identifier.issn0003-2409-
dc.identifier.urihttp://hdl.handle.net/10722/289320-
dc.description.abstractOver 30,000 adult cardiac operations are carried out in the UK annually. A small number of these patients need to return to theatre in the first few days after the initial surgery, but the exact proportion is unknown. The majority of these resternotomies are for bleeding or cardiac tamponade. The Association of Cardiothoracic Anaesthesia and Critical Care carried out a 1‐year national audit of resternotomy in 2018. Twenty‐three of the 35 centres that were eligible participated. The overall resternotomy rate (95%CI) within the period of admission for the initial operation in these centres was 3.6% (3.37–3.85). The rate varied between centres from 0.69% to 7.6%. Of the 849 patients who required resternotomy, 127 subsequently died, giving a mortality rate (95%CI) of 15.0% (12.7–17.5). In patients who underwent resternotomy, the median (IQR [range]) length of stay on ICU was 5 (2–10 [0–335]) days, and time to tracheal extubation was 20 (12–48 [0–2880]) hours. A total of 89.3% of patients who underwent resternotomy were transfused red cells, with a median (IQR [range]) of 4 (2–7 [1–1144]) units of red blood cells. The rate (95%CI) of needing renal replacement therapy was 23.4% (20.6–26.5). This UK‐wide audit has demonstrated that resternotomy after cardiac surgery is associated with prolonged intensive care stay, high rates of blood transfusion, renal replacement therapy and very high mortality. Further research into this area is required to try to improve patient care and outcomes in patients who require resternotomy in the first 24 h after cardiac surgery.-
dc.languageeng-
dc.publisherWiley-Blackwell Publishing Ltd. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2044-
dc.relation.ispartofAnaesthesia-
dc.rightsPreprint This is the pre-peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Postprint This is the peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.-
dc.subjectcardiac arrest-
dc.subjectcardiac surgery-
dc.subjecthaemorrhage-
dc.subjectresternotomy-
dc.titleThe incidence and effect of resternotomy following cardiac surgery on morbidity and mortality: a 1‐year national audit on behalf of the Association of Cardiothoracic Anaesthesia and Critical Care-
dc.typeArticle-
dc.identifier.emailChoi, SW: htswchoi@hku.hk-
dc.identifier.authorityChoi, SW=rp02552-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/anae.15070-
dc.identifier.pmid32406071-
dc.identifier.scopuseid_2-s2.0-85084516538-
dc.identifier.hkuros316582-
dc.identifier.volume76-
dc.identifier.issue1-
dc.identifier.spage19-
dc.identifier.epage26-
dc.identifier.isiWOS:000532530200001-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl0003-2409-

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