FP1.4 - Re-audit of perioperative outcomes after colorectal cancer surgery evaluating the impact of ward based level 1 critical care facility in a DGH

Abstract Aim To evaluate the perioperative outcomes after colorectal cancer surgeries in a ring-fenced pathway and compare the outcomes pre and post implementation of a ward based level 1 critical care facility in a DGH. Method Two retrospective audits were conducted, each over 6-month period, between July – December, 2020 (audit 1) and between July – December, 2022 (re-audit after the introduction of fully functional ward based enhanced care unit - ECU). Data collection tool included – patient demographics, tumour staging, ASA, intra-op access, ITU stay, ECU stay, return to theatre, unplanned re-admissions, LOS in hospital, 30-day & 90-day mortality rate. Results Audit-1 had 65 cancer surgeries, 66% being recto-sigmoid resections. 66% had laparoscopic and 34% had open procedure. 72% of these patients used ITU bed with a total of 252 bed days. Median length of stay in-hospital was 8 days. The unplanned return to theatre was 2.9%, readmission was 1.5% and 90 day mortality was 1.5%. Re-audit had 91 cancer surgeries, 65% being recto-sigmoid resections. 79% had laparoscopic and 21% had open procedure. 29% of these patients used ITU bed with a total of 87 bed days. Median length of stay in-hospital was 6 days. The unplanned return to theatre was 1%, readmission was 1% and 90 day mortality was 1.1%. The ECU was utilised by 55% of patients with a total of 186 ECU bed days and median stay of 4 days. Conclusion With the introduction of ECU facility, the perioperative outcomes have improved and there is a significant reduction in the ITU bed days.