American journal of surgery · 2016
Colorectal cancer: Quality of surgical care in Michigan.
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Kanters Arielle, Mullard Andrew J, Arambula Jennifer, Fasbinder Laurie, Krapohl Greta, Wong Sandra L, Campbell Darrell A, Hendren Samantha
Аннотация
OBJECTIVE: Surgery remains the cornerstone therapy for colorectal cancer (CRC). This study assesses CRC quality measures for surgical cases in Michigan.
METHODS: In this retrospective cohort study, processes of care and outcomes for CRC resection cases were abstracted in 30 hospitals in the Michigan Surgical Quality Collaborative (2014-2015). Measures were case-mix and reliability adjusted, using logistic regression models.
RESULTS: For 871 cases (640 colon cancer, 231 rectal cancer), adjusted morbidity (27.4%) and mortality rates (1.5%) were low. Adjusted process measures showed gaps in quality of care. Mesorectal excision was documented in 59.4% of rectal cancer (RC) cases, 65% of RC cases had sphincter preserving surgery, 18.7% of cases had < 12 lymph nodes examined, 7.9% had a positive margin, 52.1% of stage II/III RC cases had neoadjuvant therapy, and 36% of ostomy cases had site marking.
CONCLUSION: This study finds gaps in quality of care measures for CRC, suggesting opportunity for regional quality improvement.
METHODS: In this retrospective cohort study, processes of care and outcomes for CRC resection cases were abstracted in 30 hospitals in the Michigan Surgical Quality Collaborative (2014-2015). Measures were case-mix and reliability adjusted, using logistic regression models.
RESULTS: For 871 cases (640 colon cancer, 231 rectal cancer), adjusted morbidity (27.4%) and mortality rates (1.5%) were low. Adjusted process measures showed gaps in quality of care. Mesorectal excision was documented in 59.4% of rectal cancer (RC) cases, 65% of RC cases had sphincter preserving surgery, 18.7% of cases had < 12 lymph nodes examined, 7.9% had a positive margin, 52.1% of stage II/III RC cases had neoadjuvant therapy, and 36% of ostomy cases had site marking.
CONCLUSION: This study finds gaps in quality of care measures for CRC, suggesting opportunity for regional quality improvement.
Предметные рубрики MeSH
AgedAnal CanalBlood TransfusionCohort StudiesColorectal NeoplasmsFemaleHumansLength of StayLymph NodesMaleMichiganMiddle AgedMinimally Invasive Surgical ProceduresNeoadjuvant TherapyOrgan Sparing TreatmentsOstomyPatient ReadmissionQuality of Health CareReoperationRetrospective StudiesSurgical Wound Infection