FTP5.3 The Use of High Risk MDT in Assessing Patients for Elective Surgery
Hannah Dunlop- Surgery
Abstract
Aims
The High-Risk MDT is an opportunity for patients to meet with consultants in surgery, medicine and anaesthetics who are involved in their care and come to a joined decision about their care. The aim of this audit was to review the patients referred and their outcomes over a year, particularly the mortality of those recommended for surgery verses those not and use of objective risk scores.
Methods
Data was collected for all patients referred to the MDT from March 2021 to February 2022, including patient demographics, comorbidities, if there was an objective morbidity or mortality risk documented to be explained to the patient, as well as the MDT recommendation and subsequent mortality. 65 patients were referred; one repeat referral was excluded as were eight patients where no notes from the MDT meeting could be found and two that were referred to tertiary centre, leaving 54 patients for analysis.
Results
17% of patients had a documented risk of morbidity or mortality, with 4 patient notes documenting a validated objective risk score (POSSUM, SORT, NSQIP). 54% of those referred to the high-risk MDT were deemed not fit for surgery, with a mortality rate of 33%. 46% of those referred to the high-risk MDT were recommended for surgery, with a 2% mortality rate.
Conclusions
The high risk MDT is a helpful process for patients and staff but there is a lack of standardisation in the risk assessment used and documentation at these meetings, meaning that there is much variation in patient experience.