Successfully reported this slideshow.
1




DOPPLER GUIDED INTRAOPERATIVE
FLUID MANAGEMENT: DATA
ANALYSIS



  NHS Technology Adoption Centre, January 2010.
Intervention vs. Comparator
2


     Intervention (n = 626)
       London: 1st April 2008 – 30th April 2009;
       Manche...
Surgical Procedures
3


     Orthopaedics: Joint Replacement.

     Lower GI: Hartmann’s, Colectomy, Hemicolectomy.

     ...
Pre-operative Morbidity Risk
4
    Assessment POSSUM: All Patients
67% Decrease in Operative Mortality Rate
5
Intra-operative fluids administered: All
6
    Patients
Length of Stay: All Patients
7
Post-operative Length of Stay: All
8
    Patients
23% Decrease in Central Venous
9
    Catheter Insertion Rates
33% Decrease in Re-admission Rate
10
25% Decrease in Re-operation Rate
11
Critical Care Admission
12
Critical Care Length of Stay
13


      Level 1:
        Mean LOS – Intervention 3.11 Days, Control 2.95 Days.
        Med...
Critical Care LOS: Level 1
14
Critical Care LOS: Level 2
15
Critical Care LOS: Level 3
16
Statistical significance
17


      POSSUM score - Independent t-test
        Two-sided P = 0.020; Significant differences...
Statistical significance
18


      CVC insertion - Independent t-test
        Two-sided P = 0.000; Significant difference...
Statistical significance
19


      Mortality rate – Independent t-test
        Two-sided P = 0.001; Significant differenc...
Results Summary
20

      67% Decrease in Mortality

      Three Day Reduction in Length of Stay

      Four Day Reduction...
Upcoming SlideShare
Loading in …5
×

Doppler Guided Intraoperative Fluid Management Data Analysis

1,828 views

Published on

Published in: Health & Medicine, Technology
  • Be the first to comment

  • Be the first to like this

Doppler Guided Intraoperative Fluid Management Data Analysis

  1. 1. 1 DOPPLER GUIDED INTRAOPERATIVE FLUID MANAGEMENT: DATA ANALYSIS NHS Technology Adoption Centre, January 2010.
  2. 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. 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. 4. Pre-operative Morbidity Risk 4 Assessment POSSUM: All Patients
  5. 5. 67% Decrease in Operative Mortality Rate 5
  6. 6. Intra-operative fluids administered: All 6 Patients
  7. 7. Length of Stay: All Patients 7
  8. 8. Post-operative Length of Stay: All 8 Patients
  9. 9. 23% Decrease in Central Venous 9 Catheter Insertion Rates
  10. 10. 33% Decrease in Re-admission Rate 10
  11. 11. 25% Decrease in Re-operation Rate 11
  12. 12. Critical Care Admission 12
  13. 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. 14. Critical Care LOS: Level 1 14
  15. 15. Critical Care LOS: Level 2 15
  16. 16. Critical Care LOS: Level 3 16
  17. 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. 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. 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. 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

×