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NICOR Adult Cardiac Surgery Report 2022

27 June 2022 (Last updated: 27 Jun 2022 13:28)

NICOR Report 

Dear Colleagues

The 2022 report from the National Adult Cardiac Surgery Audit has now been published.   This covers the period from 2018 to 2021. 

The full Summary report and an Appendix of additional data can be accessed via:

https://www.nicor.org.uk/adult-cardiac-surgery-surgery-audit/

Some key findings of the latest report are:

 

  • In 2020/21 only 19,333 adult heart operations were performed (a fall of 34%). Around 10,000 patients did not have heart surgery that should have done across the UK (compared to the previous year).

 

  • Adult surgery activity reduced by 80% and 60% during the two peaks of COVID-19 admissions. Reduction in activity varied hugely between cardiac centres with drops ranging between 7% and 53%.

 

  • In England there was a 21% increase (to 125 days), in Northern Ireland a 61% increase (197 days), and in Wales a 94% increase (252 days) in waiting times for elective CABG surgery.

 

  • Waiting times for urgent CABG decreased from 11 to 10 days in UK. But only 3 hospitals met the 7 day target.

 

  • Day of Surgery Admission (DOSA) rates fell by over 50% last year to only 8.3% of elective admissions (from 19.6% the previous year). No hospital achieved the target (of 50%) in 2020/21 (compared to 4 in 2019/20).

 

  • Reoperation for bleeding rates following isolated CABG last year remained low at 1.78%. Stroke rates fell to 0.6%. The rate of the most serious type of sternal wound infection was very low at 0.14%.

 

  • Total coronary artery procedures (PCI and CABG combined) fell by 13%.  The ratio of PCI to CABG rose from 7:1 to 10:1 last year.

 

  • Total aortic valve procedures (TAVI and AVR combined) fell by 17%. TAVI increased by 11% whereas AVR fell by 40%. The ratio of TAVI to AVR rose from 1.2:1 to 2.3:1 last year.

 

  • Due to COVID the average consultant only performed 75 operations last year (compared to 125 in 2018/19)

 

  • Surgeons in training performed 28% fewer operations last year than in the previous year.

Within the Appendix to the report there are several non-mortality measures reported at Unit level.  Alongside these are the national averages and quartiles – to help Units set benchmarks for their own performance.  This is to aid local audit meetings - in line with the Quarterly QA Program that has been established nationally over the past year or so.  These are also all available in real-time to all audit leads via NICOR’s online tools.

We hope that surgeons and their teams find the latest report helpful.   We are very grateful for the huge amount of work by individuals across every hospital for submitting their data in a timely fashion, despite the challenges of the pandemic, allowing the much faster dissemination of results than has previously been possible.

Yours sincerely,

Andrew Goodwin – Audit Lead NICOR

Uday Trivedi – SCTS Audit Lead

Simon Kendall – SCTS President

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