RESULTS Case context and patient demographics
In the period between 2015 and 2020 inclusive there were 784 relevant cases reported. Their distribution by year and case status is shown in Table 1. The majority of cases have completed the audit process (88.8%), although the most recent data demonstrate a high proportion of cases still awaiting submission (i.e. ‘Surgical case pending’, 25.3%). Those noted as ‘terminal care’ (n = 113, 14.4%) were excluded from the full audit process leaving 671 cases for analysis. Table 1: Distribution of ACTASM cases according to audit status (n, %) Case status
2015
2016
2017
2018
2019
2020
Overall
Surgical case pending
0 (0.0)
0 (0.0)
0 (0.0)
4 (3.4)
6 (5.9)
24 (25.3)
34 (5.1)
First-line pending
0 (0.0)
0 (0.0)
0 (0.0)
3 (2.5)
2 (2.0)
6 (6.3)
11 (1.6)
Second-line pending
0 (0.0)
0 (0.0)
1 (0.7)
5 (4.2)
9 (8.8)
6 (6.3)
21 (3.1)
Lost to follow-up
1 (0.9)
1 (0.9)
5 (3.6)
2 (1.7)
0 (0.0)
0 (0.0)
9 (1.3)
Closed
111 (99.1)
105 (99.1)
131 (95.6)
105 (88.2)
85 (83.3)
59 (62.1)
596 (88.8)
TOTAL FOR FULL AUDIT
112
106
137
119
102
95
671
Excluded – terminal care
23 (20.4)
21 (18.6)
18 (15.9)
14 (12.4)
20 (17.7)
17 (15.0)
113 (14.4)
Note: ‘Surgical case pending’ refers to cases awaiting submission from the treating surgeon; ‘First-line pending’ refers to those cases undergoing FLA; ‘Second-line pending’ refers to those cases undergoing SLA; ‘Lost to follow-up’ refers to cases that have not completed the audit process but where the treating surgeon has retired, moved overseas or passed away; ‘Closed’ cases have completed the audit process; ‘Excluded – terminal care’ refers to terminal care admissions where no therapeutic surgical intervention took place.
Table 2 displays the distribution of cases by surgical specialty. General surgery accounts for more than one-third of cases in 2020, consistent with what has been observed historically. Table 2: Distribution of ACTASM cases by specialty (n, %)
8
Surgical specialty
2015
2016
2017
2018
2019
2020
Overall
Cardiothoracic Surgery
9 (8.0)
12 (11.3)
20 (14.6)
5 (4.2)
11 (10.8)
8 (8.4)
65 (9.7)
General Surgery
51 (45.5)
41 (38.7)
57 (41.6)
43 (36.1)
36 (35.3)
36 (37.9)
264 (39.3)
Neurosurgery
26 (23.2)
22 (20.8)
21 (15.3)
21 (17.6)
18 (17.6)
14 (14.7)
122 (18.2)
Obstetrics and Gynaecology
0 (0.0)
0 (0.0)
3 (2.2)
0 (0.0)
0 (0.0)
0 (0.0)
3 (0.4)
Orthopaedic Surgery
11 (9.8)
14 (13.2)
15 (10.9)
20 (16.8)
13 (12.7)
15 (15.8)
88 (13.1)
Otolaryngology Head and Neck
1 (0.9)
0 (0.0)
2 (1.5)
0 (0.0)
1 (1.0)
1 (1.1)
5 (0.7)
Plastic Surgery
1 (0.9)
0 (0.0)
0 (0.0)
2 (1.7)
2 (2.0)
4 (4.2)
9 (1.3)
Urology
0 (0.0)
5 (4.7)
4 (2.9)
9 (7.6)
5 (4.9)
1 (1.1)
24 (3.6)
Vascular Surgery
13 (11.6)
12 (11.3)
15 (10.9)
19 (16.0)
16 (15.7)
16 (16.8)
91 (13.6)
TOTAL
112
106
137
119
102
95
671
ROYAL AUSTRALASIAN COLLEGE OF SURGEONS
