Literature DB >> 24928187

Measuring surgical quality: a national clinical registry versus administrative claims data.

Laura M Enomoto1, Christopher S Hollenbeak, Neil H Bhayani, Peter W Dillon, Niraj J Gusani.   

Abstract

BACKGROUND: This study compared postoperative complications of patients who underwent pancreaticoduodenectomy (PD) recorded in the National Surgical Quality Improvement Program (NSQIP) to patients who underwent PD recorded in the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS).
METHODS: Data included 8,822 PD cases recorded in NSQIP and 9,827 PD cases recorded in NIS performed between 2005 and 2010. Eighteen postoperative adverse outcomes were identified in NSQIP and then matched to corresponding International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes in NIS. Using logistic regression, the relationship between database and postoperative complications was determined while accounting for patient factors.
RESULTS: Patients undergoing PD in the NIS were more likely to have several adverse outcomes, including urinary tract infection (odds ratio (OR) = 1.42, p < 0.001), pneumonia (OR = 1.51, p < 0.001), renal insufficiency (OR = 2.39, p < 0.001), renal failure (OR = 1.67, p = 0.005), graft/prosthetic failure (OR = 9.35, p < 0.001), and longer length of stay (1.1 days, p < 0.001). They were less likely to have cardiac arrest (OR = 0.45, p = 0.002), postoperative sepsis (OR = 0.38, p < 0.001), deep vein thrombosis (OR = 0.18, p < 0.001), and cerebrovascular accident (OR = 0.04, p = 0.003).
CONCLUSIONS: There is considerable discordance between NSQIP and NIS in the assessment of postoperative complications following PD, which underscores the value of recognizing the capabilities and limitations of each data source.

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Year:  2014        PMID: 24928187     DOI: 10.1007/s11605-014-2569-2

Source DB:  PubMed          Journal:  J Gastrointest Surg        ISSN: 1091-255X            Impact factor:   3.452


  42 in total

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2.  Can administrative data be used to ascertain clinically significant postoperative complications?

Authors:  Patrick S Romano; Michael E Schembri; Julie A Rainwater
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5.  Deriving literature-based benchmarks for surgical complications in high-income countries: a protocol for a systematic review and meta-analysis.

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6.  Guide to Enhanced Recovery for Cancer Patients Undergoing Surgery: Pancreaticoduodenectomy.

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