Leonie R van der Werf1, Niels F M Kok2, Carlijn I Buis3, Dirk J Grünhagen4, Frederik J H Hoogwater3, Rutger Jan Swijnenburg5, Marcel den Dulk6, Kees C H C Dejong6, Joost M Klaase3. 1. Dutch Institute for Clinical Auditing, Scientific Bureau, Leiden, the Netherlands. Electronic address: L.R.vdwerf@gmail.com. 2. Netherlands Cancer Institute, Department of Surgery, Amsterdam, the Netherlands. 3. University Medical Centre Groningen, Department of Surgery, Groningen, the Netherlands. 4. Erasmus University Medical Centre, Department of Surgery, Rotterdam, the Netherlands. 5. Amsterdam UMC, Department of Surgery, University of Amsterdam, the Netherlands. 6. Maastricht University Medical Centre, Department of Surgery, Maastricht, the Netherlands.
Abstract
BACKGROUND: The Dutch Hepato Biliary Audit (DHBA) was initiated in 2013 to assess the national quality of liver surgery. This study aimed to describe the initiation and implementation of this audit along with an overview of the results and future perspectives. METHODS: Registry of patients undergoing liver surgery for all primary and secondary liver tumors in the DHBA is mandatory. Weekly, benchmarked information on process and outcome measures is reported to surgical teams. In this study, the first results of patients with colorectal liver metastases were presented, including results of data verification. RESULTS: Between 2014 and 2017, 6241 procedures were registered, including 4261 (68%) resections for colorectal liver metastases. For minor- and major liver resections for colorectal liver metastases, the median [interquartile range] hospital stay was 6 [4-8] and 8 [6-12] days, respectively. A postoperative complicated course (complication leading to >14 days of hospital stay, reintervention or death) occurred in 26% and 43% and the 30-day/in-hospital mortality was 1% and 4%, respectively. The completeness of data was 97%. In 3.6% of patients, a complicated postoperative course was erroneously omitted. CONCLUSION: Nationwide implementation of the DHBA has been successful. This was the first step in creating a complete evaluation of the quality of liver surgery.
BACKGROUND: The Dutch Hepato Biliary Audit (DHBA) was initiated in 2013 to assess the national quality of liver surgery. This study aimed to describe the initiation and implementation of this audit along with an overview of the results and future perspectives. METHODS: Registry of patients undergoing liver surgery for all primary and secondary liver tumors in the DHBA is mandatory. Weekly, benchmarked information on process and outcome measures is reported to surgical teams. In this study, the first results of patients with colorectal liver metastases were presented, including results of data verification. RESULTS: Between 2014 and 2017, 6241 procedures were registered, including 4261 (68%) resections for colorectal liver metastases. For minor- and major liver resections for colorectal liver metastases, the median [interquartile range] hospital stay was 6 [4-8] and 8 [6-12] days, respectively. A postoperative complicated course (complication leading to >14 days of hospital stay, reintervention or death) occurred in 26% and 43% and the 30-day/in-hospital mortality was 1% and 4%, respectively. The completeness of data was 97%. In 3.6% of patients, a complicated postoperative course was erroneously omitted. CONCLUSION: Nationwide implementation of the DHBA has been successful. This was the first step in creating a complete evaluation of the quality of liver surgery.
Authors: Lidia S van Huizen; Pieter U Dijkstra; Patrick H J Hemmer; Boudewijn van Etten; Carlijn I Buis; Linde Olsder; Frederike G I van Vilsteren; Kees C T B Ahaus; Jan L N Roodenburg Journal: Int J Integr Care Date: 2021-02-25 Impact factor: 5.120
Authors: A K E Elfrink; M Pool; L R van der Werf; E Marra; M C Burgmans; M R Meijerink; M den Dulk; P B van den Boezem; W W Te Riele; G A Patijn; M W J M Wouters; W K G Leclercq; M S L Liem; P D Gobardhan; C I Buis; K F D Kuhlmann; C Verhoef; M G Besselink; D J Grünhagen; J M Klaase; N F M Kok Journal: BJS Open Date: 2020-05-06
Authors: P B Olthof; A K E Elfrink; E Marra; E J T Belt; P B van den Boezem; K Bosscha; E C J Consten; M den Dulk; P D Gobardhan; J Hagendoorn; T N T van Heek; J N M IJzermans; J M Klaase; K F D Kuhlmann; W K G Leclercq; M S L Liem; E R Manusama; H A Marsman; J S D Mieog; S J Oosterling; G A Patijn; W Te Riele; R-J Swijnenburg; H Torrenga; P van Duijvendijk; M Vermaas; N F M Kok; D J Grünhagen Journal: Br J Surg Date: 2020-03-24 Impact factor: 6.939