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OT audit 2016
1) This document summarizes the neurosurgery cases and ICU census from January to December 2016 at AIIMS, New Delhi. It provides statistics on the number and types of neurosurgery cases, patient demographics, procedures performed, and ICU admissions and outcomes. 2) A total of 1280 neurosurgery cases were performed in 2016, with the highest number in March (140) and the lowest in September (90). The majority were emergency cases (60%) and most patients were male (86%). 3) In the ICU, 1407 patients were admitted in 2016, most from the emergency department (71%). Head injury was the leading cause of admission (78%). The mortality rate was 6.8% compared
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OT audit 2016
- 1. OT CENSUS 1st JANUARY2016 TO 31st DECEMBER 2016 DEPARTMENT OF NEUROANAESTHESIOLOGY JPNATC AIIMS NEW DELHI
- 2. 0 20 40 60 80 100 120 140 JAN FEB MARAPR MAY JUN JUL AUG SEP OCT NOV DEC 125 105 108 114 104 99 90 120 96 98 116 105 NO.OFCASES MONTH TOTAL NO. OF NEURO SURGERY CASES= 1280
- 3. CASE DISTRIBUTION ROUTINE CASESEMERGENCY CASES 513 CASES (40%) 767 CASES (60%)
- 4. SEX DISTRIBUTION MALES FEMALES 181(14%) 1099 (86%)
- 5. AGE DISTRIBUTION ADULT PAEDIATRICGERIATRIC 51(4%) 124 (10%) 1105 (86%)
- 6. NEUROSURGICAL PROCEDURES 0 50 100 150 200 250 300 350 400 450 DECOMPRESSIVE CRANIOTOMY CRANIOPLASTY CERVICALSPINE DORSOLUMBAR SPINE VP SHUNT 414 149 220 142 70
- 7. NEUROSURGICAL PROCEDURES 0 20 40 60 80 100 120 140 160 BRACHIAL PLEXUS INJURY OMAYADRAINS INFECTED BONE REMOVAL OTHERS 145 4 14 122
- 8. ANAESTHESIA MANAGEMENT GA MAC 49(4%) 1231 (96%)
- 9. AIRWAY MANAGEMENT 200 120 777 159 FOB ASSISTEDINTUBATION SAD DL ETI VAL ETI
- 10. ASA STATUS ASA 1ASA 2 ASA 3 ASA 4 ASA 5 ASA 6 173 (13.52%) 53 (4.14%) 513 (40.07%) 259 (20.23%) 282 (22.03%)
- 11.
- 12. PATIENT POSITIONING 882 (68.90%) SUPINEPRONE LATERAL 887 (69.30%) 362 (28.29%) 31 (2.42%)
- 13. CENTRAL VENOUS LINEPLACEMENT IJV SCV 87 (25.22%) 258 (74.78%)
- 14. USE OF CELLSAVER - 22 INCIDENCE OF CARDIAC ARREST – NIL EXPIRED ON TABLE - NIL
- 15. PATIENT SHIFTING SHIFTED TOWARD SHIFTED TO ICU 549 (42.89%) 731 (57.11%)
- 16. 2015 2016 TOTAL NO.OF NEUROSURGERY CASES 1347 1280 EMERGENCY:ROUTINE 613:734 513:767 MALES:FEMALES 1105:242 1099:181 ADULT:PAEDIATRIC:GERIATRIC 1156:141:50 1105:124:51
- 17. 2015 2016 ANAESTHESIA MANAGEMENT (GA:MAC) 1166:1811231:49 INCIDENCE OF CARIDAC ARREST NIL NIL DEATH ON TABLE NIL NIL SHIFTED TO WARD:ICU 625:722 731:549
- 18. TC3 ICU Census2016 1st JAN 2016 to 31st DEC 2016
- 19. ICU setup 1.Total no.ofbeds:- 20 ( with 5 cubicles of 4 beds each) 2.Faculty :- 2 3.Senior Residents :- 4
- 20. 2016 Admissions • Totalno.of pts :- 1407 • Split:- 1) OT:- 549 2) Ward:- 87 3) ED:- 771 55% 39% 6% ED OT Ward
- 21. 771 755 770 549561 467 87 105 96 0 100 200 300 400 500 600 700 800 900 2016 2015 2014 ED OT Ward Comparisons with previous years
- 22. Male : Female= 1174 : 233 83% 17% Male Female
- 23. Cause of Admissions •Head injury:- 1109 • Spine injury:- 250 • Both head and spine:- 48 78% 18% 4% Head Injury Spine Injury Both
- 24. Comparisons with previousyears 1109 1100 1023 250 266 269 48 55 41 0 200 400 600 800 1000 1200 2016 2015 2014 Head Injury Spine Injury Both
- 25.
- 26. MORTALITY Comparisons withprevious years 6.8% (2016) 8.3%(2015) 8.9% (2014) 0 1 2 3 4 5 6 7 8 9 10 1 2 3
- 27. CAUSES OF DEATH •1) Raised ICP/ Severe Head injury:- 57 (59.4%) • 2) Shock(cardiogenic, spinal):- 17 (17.7%) • 3) ARDS:- 10 (10.4%) • 4) Sepsis:- 12 (12.5%) 59% 18% 10% 13% Causes of Death Raised ICP Shock ARDS Sepsis
- 28. Procedures 1) Bronchoscopy:- 92 2)Central venous line insertion:- 203 3) Percutaneous tracheostomy:- 328 92 90 41 203 171 159 328 328 317 0 50 100 150 200 250 300 350 2016 2015 2014 Fiberoptic Bronchoscopy CVP Line Percutaneous Tracheostomy
- 29. DEVICE RELATED INFECTIONS 1)VAP/1000 VENTILATOR DAYS:- 4.58 vs 8.56 2) CR-BSI/1000 CATHETER DAYS:- 4.3 vs 5 3) CA-UTI/1000 CATHETER DAYS:- 3.35 vs 1.45
- 30. Comparisons with previousyears 4.58 4.3 3.35 8.56 5 1.45 8.8 3.6 3.56 0 1 2 3 4 5 6 7 8 9 10 VAP CLABSI CAUTI 2016 2015 2014
- 31.