|
Elective surgery >> Postoperative complications within 30 days of surgery
6% (25/430) of patients had a graft complication and 14 (3%) returned to theatre. Infections were common, affecting one in five patients undergoing an elective aneurysm repair. We did not ask specifically about MRSA but as might be expected the most common infections were chest infections (14%, 60/431) and wound infections (4%, 16/431). Only two patients developed graft infections within 30 days of surgery. 7% (31/428) of patients were reported to have had a myocardial infarction. For three patients there was no answer to this question and in another three it was unknown. No specific criteria for diagnosis of infarction were laid down in the questionnaire, so some silent myocardial infarcts may not have been reported. 45% of those who had an infarct died within 30 days of surgery. This is consistent with other reports of the grave prognosis of myocardial infarction in this context.
The incidence of clamps placed above the renal arteries (9% 37/393) seems quite high (Table 10). There were 335 cases when the clamp was applied below the renal arteries and in whom data were supplied for both the preoperative creatinine level and the outcome for renal function.
Despite a preoperative creatinine level of ≤ 125 μmol/L, 5% of patients with an infra-renal aortic clamp developed some degree of renal impairment. This figure rose to 21% for those with a preoperative creatinine level above 125 μmol/L. Four patients (1%, 4/426) were reported to have suffered a stroke within 30 days of surgery. One of the two patients who had a disabling stroke died. Two patients (0.5%, 2/427) developed ischaemic bowel, (confirmed either at laparotomy, by mucosal changes at endoscopy or at autopsy). Both patients died. 1% (4/426) of patients developed paraplegia but all survived to 30 days. This would seem to have been a more frequent event than might have been anticipated. It is a catastrophic complication. NCEPOD has no information on the consent process, so cannot comment on whether the possibility of this complication would have been explained to the patient before the operation. ‘Other’ complications were reported for 19% (68/367) of patients. Back to top |