EP 013 Lower Limb Bypass Surgery: Mortality and Readmission within 30 days

Abstract

This audit aims to determine the rates of in-hospital mortality and unplanned 30-day readmissions following lower limb bypass surgery and to identify the primary causes of readmission to target quality improvement. A retrospective analysis was conducted on clinical records of patients undergoing lower limb bypass surgery from January 2022 to January 2023. The primary data collected comprised in-hospital mortality, 30-day readmission rates, and the underlying causes of readmission. Outcomes were benchmarked against the National Vascular Registry 2020 data. Of 22 patients included, there was one in-hospital mortality case (4.55%), exceeding the national average of 2.9%. Readmission rates were also elevated at 36.36% compared to the national average of 12.0%. Surgical site infection was the leading cause of readmission, accounting for 50% of cases. Factors contributing to higher rates include patient case-mix complexity, perioperative protocols, postoperative care pathways, and ward environment. Notably, vascular patients were previously housed in mixed surgical wards, potentially increasing infection risk. The study reveals elevated mortality and readmission rates relative to national benchmarks, with surgical site infections as the primary driver of readmissions. Targeted infection control measures, including stricter preoperative preparation and enhanced postoperative care, are recommended. A dedicated vascular ward has since been implemented, warranting a follow-up audit to assess its impact on these outcomes.