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Acute Risk Change (ARC): identifying perioperative performance variation in Australian cardiac surgery (1)

Description 
Heart surgery carries a risk of death that can be calculated before the operation. This risk is dependent on patient factors (such as age and other illnesses) and the operation itself. After heart surgery, all patients go to the intensive care unit (ICU). Events that occur intraoperatively affect how unwell they are in ICU. Acute Risk Change (ARC) is calculated by subtracting the percentage risk of death preoperatively from the postoperative risk in ICU. If the risk goes up (high ARC) then this suggests performance may have been poor in the operation. As such, ARC is a measure of ‘unwellness’ compared to expectations. We have previously shown that ARC can identify outlier units, is associated with adverse events, morbidity and long term mortality. ARC is yet to be evaluated prospectively. The basis of this project will therefore be to evaluate ARC prospectively. Evaluation will include: 1) The establishment of a persistent link between the Australian and New Zealand Intensive Care Society and Australian and New Zealand Society of Cardiothoracic Surgeons database to enable contemporaneous calculation of both risks of death 2) Establishing prospective collection of ARC data nationally 3) Reporting of continuous analysis techniques using ARC
Essential criteria: 
Minimum entry requirements can be found here: https://www.monash.edu/admissions/entry-requirements/minimum
Keywords 
anaesthesia; cardiac surgery; perioperative; quality of care
School 
School of Public Health and Preventive Medicine
Available options 
Honours
Time commitment 
Full-time
Part-time
Physical location 
Alfred Centre, The Alfred Hospital
Co-supervisors 
Prof 
Christopher Reid
Prof 
David Pilcher

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