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Paul Myles

Background

The ANZCA Clinical Trials Group was established in 2004. The ANZCA CTG conducted a multicentre prospective survey to collect contemporary perioperative data in cardiac surgical patients in Australia, New Zealand and Hong Kong. These data will guide the conduct of a large 5-year multicentre trial commencing in 2005.

Aim & Method

To estimate the proportion of patients who are taking antiplatelet and other anticoagulant medication, measure postoperative blood loss, rate of anti-fibrinolytic and blood product usage, as well as variability in transfusion practices. In addition, we wanted up-to-date morbidity, mortality, and length of stay data in contemporary practice. Ethics Committee approval for this audit was provided. Data are presented as median (range) unless otherwise stated.

Result

We enrolled 454 patients from 12 hospitals, male 71%, mean (SD) age 63 (14) yr. Most underwent elective (60%) or urgent (36%) surgery; 7% underwent redo surgery. Surgery included CABG (52%), OPCAB (6%), valve (24%), and aortic (12%) procedures. About one-third (36%) of patients had received aspirin preoperatively (median 2 days). About half (49%) received antifibrinolytic therapy. The ICU LOS was 23 (2-721) h, and duration of mechanical ventilation 11 (2-270) h. Extensive transfusion data will be presented at the meeting. Postoperatively, aspirin was instituted in 56% of patients, at 22 (3-632) h. The 30-day mortality rate was 3%.

Conclusion

Many patients are exposed to antiplatelet medications preoperatively, and most of these receive antifibrinolytic therapy. The cost and outcome benefits of these interventions are unknown.

Time of Presentation
Saturday 7 May 2005 - 1330-1500