AB018. 65. An observational study of perioperative outcome measures in patients undergoing nephrectomy

Background: In 2015 the ESA-ESICM joint taskforce published their perioperative outcome measures. The report describes definitions for 22 individual adverse events with a system of severity grading for each. This will provide clearly defined and patient relevant outcome measures for large clinical trials in perioperative medicine and clinical audit. We decided to conduct an initial observational study of these adverse events for patients undergoing nephrectomy in Warrington Hospital NHS Trust.

Methods: In our Trust, all patients who have nephrectomies are admitted to ICU post-operatively. We looked at the incidence of all 22 outcome measures in the 30 days post-operative period in 2017. We used our electronic record system to access the data and input this into an excel proforma.

Results: There were 22 patients included, mean age was 65 and median length of stay was 7.5 days. Of the 22 patients included 18 experienced at least 1 adverse event. Ten patients developed a stage 1 acute kidney injury (AKI). Other recorded adverse events were of cardiac (n=2), pulmonary (n=1) and surgical (n=4) nature. In total there were 22 adverse events recorded.

Conclusions: Eighty-one percent of patients experienced an adverse event but all were graded mild. We intend to broaden this study to measure additional patient groups, in order to improve overall perioperative care in Warrington. We consider the ESA-ESICM joint taskforce perioperative outcome measures a useful and effective tool for the future of perioperative medicine.

Keywords: Perioperative; nephrectomy; nephrectomies