BACKGROUND: Our study compares 30-day vs. 90-day mortality following colorectal cancer surgery (CRS), and examines hospital performance ranking based on this assessment. METHODS: Mortality rates were compared between 30 vs. 90 days following CRS for patients with stage I-III colorectal cancers from the National Cancer Database (2004-2012). Risk-adjusted hierarchical regression models evaluated hospital performance based on mortality. Hospitals were ranked into top (10%), middle (80%), and lowest (10%) performance groups. RESULTS: Among 185,464 patients, 90-day mortality was nearly double the 30-day mortality (4.4% vs. 2.5%). Following risk adjustment 176 hospitals changed performance ranking: 39% in the top 30-day mortality group changed ranking to the middle group; 37% of hospitals in the lowest 30-day group changed ranking to the middle 90-day group. CONCLUSIONS: Evaluation of hospital performance based on 30-day mortality is associated with misclassification for 15% of hospitals. Ninety-day mortality may be a better quality metric in oncologic CRS.
BACKGROUND: Our study compares 30-day vs. 90-day mortality following colorectal cancer surgery (CRS), and examines hospital performance ranking based on this assessment. METHODS: Mortality rates were compared between 30 vs. 90 days following CRS for patients with stage I-III colorectal cancers from the National Cancer Database (2004-2012). Risk-adjusted hierarchical regression models evaluated hospital performance based on mortality. Hospitals were ranked into top (10%), middle (80%), and lowest (10%) performance groups. RESULTS: Among 185,464 patients, 90-day mortality was nearly double the 30-day mortality (4.4% vs. 2.5%). Following risk adjustment 176 hospitals changed performance ranking: 39% in the top 30-day mortality group changed ranking to the middle group; 37% of hospitals in the lowest 30-day group changed ranking to the middle 90-day group. CONCLUSIONS: Evaluation of hospital performance based on 30-day mortality is associated with misclassification for 15% of hospitals. Ninety-day mortality may be a better quality metric in oncologic CRS.
Authors: Marianna V Papageorge; Benjamin J Resio; Andres F Monsalve; Maureen Canavan; Ranjan Pathak; Vincent J Mase; Andrew P Dhanasopon; Jessica R Hoag; Justin D Blasberg; Daniel J Boffa Journal: JNCI Cancer Spectr Date: 2020-07-07
Authors: R P Vogelsang; R D Bojesen; E R Hoelmich; A Orhan; F Buzquurz; L Cai; C Grube; J A Zahid; E Allakhverdiiev; H H Raskov; I Drakos; N Derian; P B Ryan; P R Rijnbeek; I Gögenur Journal: BJS Open Date: 2021-05-07
Authors: Jessica R Hoag; Benjamin J Resio; Andres F Monsalve; Alexander S Chiu; Lawrence B Brown; Jeph Herrin; Justin D Blasberg; Anthony W Kim; Daniel J Boffa Journal: JAMA Netw Open Date: 2019-04-05
Authors: Derek Mao; Therese Rey-Conde; John B North; Raymond P Lancashire; Sanjeev Naidu; Terence C Chua Journal: World J Surg Date: 2022-04-04 Impact factor: 3.282