Timeliness of pre-operative aspirin before coronary artery bypass grafting (CABG): A clinical audit

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Coronary artery disease undergoing isolated coronary artery bypass grafting (CABG) (n=60). Intervention: Pre-operative aspirin (Ecosprin) administration vs. Predefined institutional audit benchmark (≥80% compliance). Primary outcome: Compliance with pre-operative Ecosprin administration (95% CI 81.6-97.2, p=0.023).

Q: What does this research mean for the field?

Pre-operative aspirin is administered to 91.7% of eligible isolated CABG patients, significantly exceeding an 80% institutional audit benchmark. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Surendra Singh Yadav

doi:10.6026/973206300227142

October 31, 2026BioinformationOpen Access

Timeliness of pre-operative aspirin before coronary artery bypass grafting (CABG): A clinical audit

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Key result

Pre-operative aspirin administration reaches ~92% in isolated CABG, significantly exceeding the institutional benchmark.

95% CI 81.6-97.2
P=0.023
n=60

Why the study?

Omission or poorly timed aspirin before CABG may compromise graft patency and post-operative outcomes, motivating an evaluation of compliance with evidence-based recommendations for timely pre-operative aspirin administration.

Key Points

To evaluate institutional adherence to evidence-based standards for timely pre-operative aspirin administration in patients undergoing isolated coronary artery bypass grafting.
Conducted a retrospective standards-based clinical audit of 60 consecutive adult patients undergoing isolated coronary artery bypass grafting at a tertiary care centre in Central India.
Evaluated performance against institutional benchmarks (target ≥80%) for pre-operative aspirin administration and delivery within 24 hours prior to surgery.
Pre-operative aspirin was administered to 91.7% of patients (55 of 60; 95% CI 81.6–97.2), significantly exceeding the institutional benchmark of ≥80% (p=0.023).
Aspirin was given within the recommended 24 hours prior to surgery in 86.7% of patients (52 of 60; 95% CI 75.4–94.1), achieving the ≥80% standard without statistical significance (p=0.26).
Among non-compliant cases (n=8), primary causes were medication omission (37.5%), inadequate documentation (25.0%), surgeon-directed discontinuation (25.0%), and emergency scheduling (12.5%).

Study Design

Type

Observational (n=60)

Multicenter

No

Structured PICO

P

Population

60 consecutive adults (mean age 61.8 years, 23.3% female) undergoing isolated coronary artery bypass grafting without aspirin contraindications at a single Indian center between September 2024 and July 2025.

E

Exposure

Pre-operative aspirin administration within 24 hours before CABG (categorized as ≤6 hours, 6–12 hours, or 12–24 hours before surgery)

C

Comparator

Predefined institutional audit standard requiring at least 80% of eligible CABG patients to receive pre-operative aspirin and at least 80% to receive it within 24 hours before surgery

O

Outcome

Compliance with pre-operative aspirin administration against a predefined institutional audit standard of ≥80%

Main Result

Absolute Event Rate: 91.7% vs 80%

p-value: p=0.023

This clinical audit demonstrated high adherence to guideline-recommended pre-operative aspirin administration before isolated CABG (91.7% overall, 86.7% within 24 hours), while identifying medication omission and inadequate documentation as primary targets for quality improvement.

Limitations

Retrospective, single-centre design
Relatively small sample size (n = 60)
Clinical outcomes such as perioperative bleeding, transfusion requirements, graft patency, myocardial infarction, and mortality were not evaluated
Retrospective design
Single-centre design
Relatively small sample size
Clinical outcomes such as perioperative bleeding, transfusion requirements, graft patency, myocardial infarction and mortality were not evaluated

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Implication

Exceeds institutional standards for pre-operative aspirin before CABG; supports local adherence but leaves open multicenter confirmation.

Abstract

Omission or poorly timed aspirin before coronary artery bypass grafting (CABG) may compromise graft patency and post-operative outcomes. Therefore, it is of interest to evaluate the compliance with evidence-based recommendations for timely pre-operative aspirin administration at a tertiary care centre in Central India. A retrospective standards-based audit of 60 consecutive adult patients undergoing isolated CABG was conducted against predefined institutional standards. Aspirin was administered to 91.7% of eligible patients, and 86.7% received the last dose within 24 hours of surgery, exceeding the audit benchmark. Thus, medication omission, inadequate documentation and surgeon-directed discontinuation were the main causes of non-compliance, indicating a need for better documentation and medication reconciliation.

Discussion

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Cite This Study

Surendra Singh Yadav (2026) conducted an observational in Coronary artery disease undergoing isolated coronary artery bypass grafting (CABG) (n=60). Pre-operative aspirin (Ecosprin) administration vs. Predefined institutional audit benchmark (≥80% compliance) was evaluated on Compliance with pre-operative Ecosprin administration (95% CI 81.6-97.2, p=0.023). Pre-operative aspirin was administered to 91.7% (95% CI 81.6–97.2) of eligible isolated CABG patients, significantly exceeding the 80% institutional audit standard (p=0.023).

synapsesocial.com/papers/6aee6bc771a7594806220b5c https://doi.org/10.6026/973206300227142

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Timeliness of pre-operative aspirin before coronary artery bypass grafting (CABG): A clinical audit

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Timeliness of pre-operative aspirin before coronary artery bypass grafting (CABG): A clinical audit

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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