Hospital Variation in Failure to Rescue after Colorectal Cancer Surgery: Results of the Dutch Surgical Colorectal Audit

Background Postoperative mortality is frequently used in hospital comparisons as marker for quality of care. Differences in mortality between hospitals may be explained by varying complication rates. A possible modifying factor may be the ability to let patients with a serious complication survive,...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Henneman, D. [verfasserIn] Snijders, H. S. [verfasserIn] Fiocco, M. [verfasserIn] van Leersum, N. J. [verfasserIn] Kolfschoten, N. E. [verfasserIn] Wiggers, Th. [verfasserIn] Wouters, M. W. J. M. [verfasserIn] Tollenaar, R. A. E. M. [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2013

Schlagwörter:	Severe Complication Charlson Comorbidity Index Lower Quintile Hospital Variation Severe Complication Rate

Übergeordnetes Werk:	Enthalten in: Annals of surgical oncology - Berlin [u.a.] : Springer, 1994, 20(2013), 7 vom: 16. Feb., Seite 2117-2123
Übergeordnetes Werk:	volume:20 ; year:2013 ; number:7 ; day:16 ; month:02 ; pages:2117-2123

Links:	Volltext

DOI / URN:	10.1245/s10434-013-2896-7

Katalog-ID:	SPR009957855

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520			\|a Background Postoperative mortality is frequently used in hospital comparisons as marker for quality of care. Differences in mortality between hospitals may be explained by varying complication rates. A possible modifying factor may be the ability to let patients with a serious complication survive, referred to as failure to rescue (FTR). The purpose of this study was to evaluate how hospital performance on postoperative mortality is related to severe complications or to FTR and to explore the value of FTR in quality improvement programs. Methods All patients operated for colorectal cancer from 2009 to 2011, registered in the Dutch Surgical Colorectal Audit, were included. Logistic regression models were used to obtain adjusted mortality, complication, and FTR rates. Hospitals were grouped into 5 quintiles according to adjusted mortality. Outcomes were compared between quintiles. Results A total of 24,667 patients were included. Severe complications ranged from 19 % in the lowest to 25 % in the highest mortality quintile (odds ratio 1.5, 95 % confidence interval 1.37–1.67). Risk-adjusted FTR rates showed a marked difference between the quintiles, ranging from 9 % to 26 % (odds ratio 3.0, 95 % confidence interval 2.29–3.98). There was significant variability in FTR rates. Seven hospitals had significantly lower FTR rates than average. Conclusions High-mortality hospitals had slightly higher rates of severe complications than low-mortality hospitals. However, FTR was three times higher in high-mortality hospitals than in low-mortality hospitals. In quality improvement projects, feedback to hospitals of FTR rates, along with complication rates, may illustrate shortcomings (prevention or management of complications) per hospital, which may be an important step in reducing mortality.
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700	1		\|a Snijders, H. S. \|e verfasserin \|4 aut
700	1		\|a Fiocco, M. \|e verfasserin \|4 aut
700	1		\|a van Leersum, N. J. \|e verfasserin \|4 aut
700	1		\|a Kolfschoten, N. E. \|e verfasserin \|4 aut
700	1		\|a Wiggers, Th. \|e verfasserin \|4 aut
700	1		\|a Wouters, M. W. J. M. \|e verfasserin \|4 aut
700	1		\|a Tollenaar, R. A. E. M. \|e verfasserin \|4 aut
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bklnumber	44.81 44.65
publishDate	2013
allfields	10.1245/s10434-013-2896-7 doi (DE-627)SPR009957855 (SPR)s10434-013-2896-7-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Henneman, D. verfasserin aut Hospital Variation in Failure to Rescue after Colorectal Cancer Surgery: Results of the Dutch Surgical Colorectal Audit 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Postoperative mortality is frequently used in hospital comparisons as marker for quality of care. Differences in mortality between hospitals may be explained by varying complication rates. A possible modifying factor may be the ability to let patients with a serious complication survive, referred to as failure to rescue (FTR). The purpose of this study was to evaluate how hospital performance on postoperative mortality is related to severe complications or to FTR and to explore the value of FTR in quality improvement programs. Methods All patients operated for colorectal cancer from 2009 to 2011, registered in the Dutch Surgical Colorectal Audit, were included. Logistic regression models were used to obtain adjusted mortality, complication, and FTR rates. Hospitals were grouped into 5 quintiles according to adjusted mortality. Outcomes were compared between quintiles. Results A total of 24,667 patients were included. Severe complications ranged from 19 % in the lowest to 25 % in the highest mortality quintile (odds ratio 1.5, 95 % confidence interval 1.37–1.67). Risk-adjusted FTR rates showed a marked difference between the quintiles, ranging from 9 % to 26 % (odds ratio 3.0, 95 % confidence interval 2.29–3.98). There was significant variability in FTR rates. Seven hospitals had significantly lower FTR rates than average. Conclusions High-mortality hospitals had slightly higher rates of severe complications than low-mortality hospitals. However, FTR was three times higher in high-mortality hospitals than in low-mortality hospitals. In quality improvement projects, feedback to hospitals of FTR rates, along with complication rates, may illustrate shortcomings (prevention or management of complications) per hospital, which may be an important step in reducing mortality. Severe Complication (dpeaa)DE-He213 Charlson Comorbidity Index (dpeaa)DE-He213 Lower Quintile (dpeaa)DE-He213 Hospital Variation (dpeaa)DE-He213 Severe Complication Rate (dpeaa)DE-He213 Snijders, H. S. verfasserin aut Fiocco, M. verfasserin aut van Leersum, N. J. verfasserin aut Kolfschoten, N. E. verfasserin aut Wiggers, Th. verfasserin aut Wouters, M. W. J. M. verfasserin aut Tollenaar, R. A. E. M. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 20(2013), 7 vom: 16. Feb., Seite 2117-2123 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:20 year:2013 number:7 day:16 month:02 pages:2117-2123 https://dx.doi.org/10.1245/s10434-013-2896-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 20 2013 7 16 02 2117-2123
spelling	10.1245/s10434-013-2896-7 doi (DE-627)SPR009957855 (SPR)s10434-013-2896-7-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Henneman, D. verfasserin aut Hospital Variation in Failure to Rescue after Colorectal Cancer Surgery: Results of the Dutch Surgical Colorectal Audit 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Postoperative mortality is frequently used in hospital comparisons as marker for quality of care. Differences in mortality between hospitals may be explained by varying complication rates. A possible modifying factor may be the ability to let patients with a serious complication survive, referred to as failure to rescue (FTR). The purpose of this study was to evaluate how hospital performance on postoperative mortality is related to severe complications or to FTR and to explore the value of FTR in quality improvement programs. Methods All patients operated for colorectal cancer from 2009 to 2011, registered in the Dutch Surgical Colorectal Audit, were included. Logistic regression models were used to obtain adjusted mortality, complication, and FTR rates. Hospitals were grouped into 5 quintiles according to adjusted mortality. Outcomes were compared between quintiles. Results A total of 24,667 patients were included. Severe complications ranged from 19 % in the lowest to 25 % in the highest mortality quintile (odds ratio 1.5, 95 % confidence interval 1.37–1.67). Risk-adjusted FTR rates showed a marked difference between the quintiles, ranging from 9 % to 26 % (odds ratio 3.0, 95 % confidence interval 2.29–3.98). There was significant variability in FTR rates. Seven hospitals had significantly lower FTR rates than average. Conclusions High-mortality hospitals had slightly higher rates of severe complications than low-mortality hospitals. However, FTR was three times higher in high-mortality hospitals than in low-mortality hospitals. In quality improvement projects, feedback to hospitals of FTR rates, along with complication rates, may illustrate shortcomings (prevention or management of complications) per hospital, which may be an important step in reducing mortality. Severe Complication (dpeaa)DE-He213 Charlson Comorbidity Index (dpeaa)DE-He213 Lower Quintile (dpeaa)DE-He213 Hospital Variation (dpeaa)DE-He213 Severe Complication Rate (dpeaa)DE-He213 Snijders, H. S. verfasserin aut Fiocco, M. verfasserin aut van Leersum, N. J. verfasserin aut Kolfschoten, N. E. verfasserin aut Wiggers, Th. verfasserin aut Wouters, M. W. J. M. verfasserin aut Tollenaar, R. A. E. M. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 20(2013), 7 vom: 16. Feb., Seite 2117-2123 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:20 year:2013 number:7 day:16 month:02 pages:2117-2123 https://dx.doi.org/10.1245/s10434-013-2896-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 20 2013 7 16 02 2117-2123
allfields_unstemmed	10.1245/s10434-013-2896-7 doi (DE-627)SPR009957855 (SPR)s10434-013-2896-7-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Henneman, D. verfasserin aut Hospital Variation in Failure to Rescue after Colorectal Cancer Surgery: Results of the Dutch Surgical Colorectal Audit 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Postoperative mortality is frequently used in hospital comparisons as marker for quality of care. Differences in mortality between hospitals may be explained by varying complication rates. A possible modifying factor may be the ability to let patients with a serious complication survive, referred to as failure to rescue (FTR). The purpose of this study was to evaluate how hospital performance on postoperative mortality is related to severe complications or to FTR and to explore the value of FTR in quality improvement programs. Methods All patients operated for colorectal cancer from 2009 to 2011, registered in the Dutch Surgical Colorectal Audit, were included. Logistic regression models were used to obtain adjusted mortality, complication, and FTR rates. Hospitals were grouped into 5 quintiles according to adjusted mortality. Outcomes were compared between quintiles. Results A total of 24,667 patients were included. Severe complications ranged from 19 % in the lowest to 25 % in the highest mortality quintile (odds ratio 1.5, 95 % confidence interval 1.37–1.67). Risk-adjusted FTR rates showed a marked difference between the quintiles, ranging from 9 % to 26 % (odds ratio 3.0, 95 % confidence interval 2.29–3.98). There was significant variability in FTR rates. Seven hospitals had significantly lower FTR rates than average. Conclusions High-mortality hospitals had slightly higher rates of severe complications than low-mortality hospitals. However, FTR was three times higher in high-mortality hospitals than in low-mortality hospitals. In quality improvement projects, feedback to hospitals of FTR rates, along with complication rates, may illustrate shortcomings (prevention or management of complications) per hospital, which may be an important step in reducing mortality. Severe Complication (dpeaa)DE-He213 Charlson Comorbidity Index (dpeaa)DE-He213 Lower Quintile (dpeaa)DE-He213 Hospital Variation (dpeaa)DE-He213 Severe Complication Rate (dpeaa)DE-He213 Snijders, H. S. verfasserin aut Fiocco, M. verfasserin aut van Leersum, N. J. verfasserin aut Kolfschoten, N. E. verfasserin aut Wiggers, Th. verfasserin aut Wouters, M. W. J. M. verfasserin aut Tollenaar, R. A. E. M. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 20(2013), 7 vom: 16. Feb., Seite 2117-2123 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:20 year:2013 number:7 day:16 month:02 pages:2117-2123 https://dx.doi.org/10.1245/s10434-013-2896-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 20 2013 7 16 02 2117-2123
allfieldsGer	10.1245/s10434-013-2896-7 doi (DE-627)SPR009957855 (SPR)s10434-013-2896-7-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Henneman, D. verfasserin aut Hospital Variation in Failure to Rescue after Colorectal Cancer Surgery: Results of the Dutch Surgical Colorectal Audit 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Postoperative mortality is frequently used in hospital comparisons as marker for quality of care. Differences in mortality between hospitals may be explained by varying complication rates. A possible modifying factor may be the ability to let patients with a serious complication survive, referred to as failure to rescue (FTR). The purpose of this study was to evaluate how hospital performance on postoperative mortality is related to severe complications or to FTR and to explore the value of FTR in quality improvement programs. Methods All patients operated for colorectal cancer from 2009 to 2011, registered in the Dutch Surgical Colorectal Audit, were included. Logistic regression models were used to obtain adjusted mortality, complication, and FTR rates. Hospitals were grouped into 5 quintiles according to adjusted mortality. Outcomes were compared between quintiles. Results A total of 24,667 patients were included. Severe complications ranged from 19 % in the lowest to 25 % in the highest mortality quintile (odds ratio 1.5, 95 % confidence interval 1.37–1.67). Risk-adjusted FTR rates showed a marked difference between the quintiles, ranging from 9 % to 26 % (odds ratio 3.0, 95 % confidence interval 2.29–3.98). There was significant variability in FTR rates. Seven hospitals had significantly lower FTR rates than average. Conclusions High-mortality hospitals had slightly higher rates of severe complications than low-mortality hospitals. However, FTR was three times higher in high-mortality hospitals than in low-mortality hospitals. In quality improvement projects, feedback to hospitals of FTR rates, along with complication rates, may illustrate shortcomings (prevention or management of complications) per hospital, which may be an important step in reducing mortality. Severe Complication (dpeaa)DE-He213 Charlson Comorbidity Index (dpeaa)DE-He213 Lower Quintile (dpeaa)DE-He213 Hospital Variation (dpeaa)DE-He213 Severe Complication Rate (dpeaa)DE-He213 Snijders, H. S. verfasserin aut Fiocco, M. verfasserin aut van Leersum, N. J. verfasserin aut Kolfschoten, N. E. verfasserin aut Wiggers, Th. verfasserin aut Wouters, M. W. J. M. verfasserin aut Tollenaar, R. A. E. M. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 20(2013), 7 vom: 16. Feb., Seite 2117-2123 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:20 year:2013 number:7 day:16 month:02 pages:2117-2123 https://dx.doi.org/10.1245/s10434-013-2896-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 20 2013 7 16 02 2117-2123
allfieldsSound	10.1245/s10434-013-2896-7 doi (DE-627)SPR009957855 (SPR)s10434-013-2896-7-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Henneman, D. verfasserin aut Hospital Variation in Failure to Rescue after Colorectal Cancer Surgery: Results of the Dutch Surgical Colorectal Audit 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Postoperative mortality is frequently used in hospital comparisons as marker for quality of care. Differences in mortality between hospitals may be explained by varying complication rates. A possible modifying factor may be the ability to let patients with a serious complication survive, referred to as failure to rescue (FTR). The purpose of this study was to evaluate how hospital performance on postoperative mortality is related to severe complications or to FTR and to explore the value of FTR in quality improvement programs. Methods All patients operated for colorectal cancer from 2009 to 2011, registered in the Dutch Surgical Colorectal Audit, were included. Logistic regression models were used to obtain adjusted mortality, complication, and FTR rates. Hospitals were grouped into 5 quintiles according to adjusted mortality. Outcomes were compared between quintiles. Results A total of 24,667 patients were included. Severe complications ranged from 19 % in the lowest to 25 % in the highest mortality quintile (odds ratio 1.5, 95 % confidence interval 1.37–1.67). Risk-adjusted FTR rates showed a marked difference between the quintiles, ranging from 9 % to 26 % (odds ratio 3.0, 95 % confidence interval 2.29–3.98). There was significant variability in FTR rates. Seven hospitals had significantly lower FTR rates than average. Conclusions High-mortality hospitals had slightly higher rates of severe complications than low-mortality hospitals. However, FTR was three times higher in high-mortality hospitals than in low-mortality hospitals. In quality improvement projects, feedback to hospitals of FTR rates, along with complication rates, may illustrate shortcomings (prevention or management of complications) per hospital, which may be an important step in reducing mortality. Severe Complication (dpeaa)DE-He213 Charlson Comorbidity Index (dpeaa)DE-He213 Lower Quintile (dpeaa)DE-He213 Hospital Variation (dpeaa)DE-He213 Severe Complication Rate (dpeaa)DE-He213 Snijders, H. S. verfasserin aut Fiocco, M. verfasserin aut van Leersum, N. J. verfasserin aut Kolfschoten, N. E. verfasserin aut Wiggers, Th. verfasserin aut Wouters, M. W. J. M. verfasserin aut Tollenaar, R. A. E. M. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 20(2013), 7 vom: 16. Feb., Seite 2117-2123 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:20 year:2013 number:7 day:16 month:02 pages:2117-2123 https://dx.doi.org/10.1245/s10434-013-2896-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 20 2013 7 16 02 2117-2123
language	English
source	Enthalten in Annals of surgical oncology 20(2013), 7 vom: 16. Feb., Seite 2117-2123 volume:20 year:2013 number:7 day:16 month:02 pages:2117-2123
sourceStr	Enthalten in Annals of surgical oncology 20(2013), 7 vom: 16. Feb., Seite 2117-2123 volume:20 year:2013 number:7 day:16 month:02 pages:2117-2123
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Severe Complication Charlson Comorbidity Index Lower Quintile Hospital Variation Severe Complication Rate
dewey-raw	610
isfreeaccess_bool	false
container_title	Annals of surgical oncology
authorswithroles_txt_mv	Henneman, D. @@aut@@ Snijders, H. S. @@aut@@ Fiocco, M. @@aut@@ van Leersum, N. J. @@aut@@ Kolfschoten, N. E. @@aut@@ Wiggers, Th. @@aut@@ Wouters, M. W. J. M. @@aut@@ Tollenaar, R. A. E. M. @@aut@@
publishDateDaySort_date	2013-02-16T00:00:00Z
hierarchy_top_id	343969947
dewey-sort	3610
id	SPR009957855
language_de	englisch
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Differences in mortality between hospitals may be explained by varying complication rates. A possible modifying factor may be the ability to let patients with a serious complication survive, referred to as failure to rescue (FTR). The purpose of this study was to evaluate how hospital performance on postoperative mortality is related to severe complications or to FTR and to explore the value of FTR in quality improvement programs. Methods All patients operated for colorectal cancer from 2009 to 2011, registered in the Dutch Surgical Colorectal Audit, were included. Logistic regression models were used to obtain adjusted mortality, complication, and FTR rates. Hospitals were grouped into 5 quintiles according to adjusted mortality. Outcomes were compared between quintiles. Results A total of 24,667 patients were included. Severe complications ranged from 19 % in the lowest to 25 % in the highest mortality quintile (odds ratio 1.5, 95 % confidence interval 1.37–1.67). Risk-adjusted FTR rates showed a marked difference between the quintiles, ranging from 9 % to 26 % (odds ratio 3.0, 95 % confidence interval 2.29–3.98). There was significant variability in FTR rates. Seven hospitals had significantly lower FTR rates than average. Conclusions High-mortality hospitals had slightly higher rates of severe complications than low-mortality hospitals. However, FTR was three times higher in high-mortality hospitals than in low-mortality hospitals. In quality improvement projects, feedback to hospitals of FTR rates, along with complication rates, may illustrate shortcomings (prevention or management of complications) per hospital, which may be an important step in reducing mortality.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Severe Complication</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Charlson Comorbidity Index</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Lower Quintile</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Hospital Variation</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Severe Complication Rate</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Snijders, H. 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author	Henneman, D.
spellingShingle	Henneman, D. ddc 610 bkl 44.81 bkl 44.65 misc Severe Complication misc Charlson Comorbidity Index misc Lower Quintile misc Hospital Variation misc Severe Complication Rate Hospital Variation in Failure to Rescue after Colorectal Cancer Surgery: Results of the Dutch Surgical Colorectal Audit
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topic_title	610 ASE 44.81 bkl 44.65 bkl Hospital Variation in Failure to Rescue after Colorectal Cancer Surgery: Results of the Dutch Surgical Colorectal Audit Severe Complication (dpeaa)DE-He213 Charlson Comorbidity Index (dpeaa)DE-He213 Lower Quintile (dpeaa)DE-He213 Hospital Variation (dpeaa)DE-He213 Severe Complication Rate (dpeaa)DE-He213
topic	ddc 610 bkl 44.81 bkl 44.65 misc Severe Complication misc Charlson Comorbidity Index misc Lower Quintile misc Hospital Variation misc Severe Complication Rate
topic_unstemmed	ddc 610 bkl 44.81 bkl 44.65 misc Severe Complication misc Charlson Comorbidity Index misc Lower Quintile misc Hospital Variation misc Severe Complication Rate
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title	Hospital Variation in Failure to Rescue after Colorectal Cancer Surgery: Results of the Dutch Surgical Colorectal Audit
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title_full	Hospital Variation in Failure to Rescue after Colorectal Cancer Surgery: Results of the Dutch Surgical Colorectal Audit
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author_browse	Henneman, D. Snijders, H. S. Fiocco, M. van Leersum, N. J. Kolfschoten, N. E. Wiggers, Th. Wouters, M. W. J. M. Tollenaar, R. A. E. M.
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title_sort	hospital variation in failure to rescue after colorectal cancer surgery: results of the dutch surgical colorectal audit
title_auth	Hospital Variation in Failure to Rescue after Colorectal Cancer Surgery: Results of the Dutch Surgical Colorectal Audit
abstract	Background Postoperative mortality is frequently used in hospital comparisons as marker for quality of care. Differences in mortality between hospitals may be explained by varying complication rates. A possible modifying factor may be the ability to let patients with a serious complication survive, referred to as failure to rescue (FTR). The purpose of this study was to evaluate how hospital performance on postoperative mortality is related to severe complications or to FTR and to explore the value of FTR in quality improvement programs. Methods All patients operated for colorectal cancer from 2009 to 2011, registered in the Dutch Surgical Colorectal Audit, were included. Logistic regression models were used to obtain adjusted mortality, complication, and FTR rates. Hospitals were grouped into 5 quintiles according to adjusted mortality. Outcomes were compared between quintiles. Results A total of 24,667 patients were included. Severe complications ranged from 19 % in the lowest to 25 % in the highest mortality quintile (odds ratio 1.5, 95 % confidence interval 1.37–1.67). Risk-adjusted FTR rates showed a marked difference between the quintiles, ranging from 9 % to 26 % (odds ratio 3.0, 95 % confidence interval 2.29–3.98). There was significant variability in FTR rates. Seven hospitals had significantly lower FTR rates than average. Conclusions High-mortality hospitals had slightly higher rates of severe complications than low-mortality hospitals. However, FTR was three times higher in high-mortality hospitals than in low-mortality hospitals. In quality improvement projects, feedback to hospitals of FTR rates, along with complication rates, may illustrate shortcomings (prevention or management of complications) per hospital, which may be an important step in reducing mortality.
abstractGer	Background Postoperative mortality is frequently used in hospital comparisons as marker for quality of care. Differences in mortality between hospitals may be explained by varying complication rates. A possible modifying factor may be the ability to let patients with a serious complication survive, referred to as failure to rescue (FTR). The purpose of this study was to evaluate how hospital performance on postoperative mortality is related to severe complications or to FTR and to explore the value of FTR in quality improvement programs. Methods All patients operated for colorectal cancer from 2009 to 2011, registered in the Dutch Surgical Colorectal Audit, were included. Logistic regression models were used to obtain adjusted mortality, complication, and FTR rates. Hospitals were grouped into 5 quintiles according to adjusted mortality. Outcomes were compared between quintiles. Results A total of 24,667 patients were included. Severe complications ranged from 19 % in the lowest to 25 % in the highest mortality quintile (odds ratio 1.5, 95 % confidence interval 1.37–1.67). Risk-adjusted FTR rates showed a marked difference between the quintiles, ranging from 9 % to 26 % (odds ratio 3.0, 95 % confidence interval 2.29–3.98). There was significant variability in FTR rates. Seven hospitals had significantly lower FTR rates than average. Conclusions High-mortality hospitals had slightly higher rates of severe complications than low-mortality hospitals. However, FTR was three times higher in high-mortality hospitals than in low-mortality hospitals. In quality improvement projects, feedback to hospitals of FTR rates, along with complication rates, may illustrate shortcomings (prevention or management of complications) per hospital, which may be an important step in reducing mortality.
abstract_unstemmed	Background Postoperative mortality is frequently used in hospital comparisons as marker for quality of care. Differences in mortality between hospitals may be explained by varying complication rates. A possible modifying factor may be the ability to let patients with a serious complication survive, referred to as failure to rescue (FTR). The purpose of this study was to evaluate how hospital performance on postoperative mortality is related to severe complications or to FTR and to explore the value of FTR in quality improvement programs. Methods All patients operated for colorectal cancer from 2009 to 2011, registered in the Dutch Surgical Colorectal Audit, were included. Logistic regression models were used to obtain adjusted mortality, complication, and FTR rates. Hospitals were grouped into 5 quintiles according to adjusted mortality. Outcomes were compared between quintiles. Results A total of 24,667 patients were included. Severe complications ranged from 19 % in the lowest to 25 % in the highest mortality quintile (odds ratio 1.5, 95 % confidence interval 1.37–1.67). Risk-adjusted FTR rates showed a marked difference between the quintiles, ranging from 9 % to 26 % (odds ratio 3.0, 95 % confidence interval 2.29–3.98). There was significant variability in FTR rates. Seven hospitals had significantly lower FTR rates than average. Conclusions High-mortality hospitals had slightly higher rates of severe complications than low-mortality hospitals. However, FTR was three times higher in high-mortality hospitals than in low-mortality hospitals. In quality improvement projects, feedback to hospitals of FTR rates, along with complication rates, may illustrate shortcomings (prevention or management of complications) per hospital, which may be an important step in reducing mortality.
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container_issue	7
title_short	Hospital Variation in Failure to Rescue after Colorectal Cancer Surgery: Results of the Dutch Surgical Colorectal Audit
url	https://dx.doi.org/10.1245/s10434-013-2896-7
remote_bool	true
author2	Snijders, H. S. Fiocco, M. van Leersum, N. J. Kolfschoten, N. E. Wiggers, Th Wouters, M. W. J. M. Tollenaar, R. A. E. M.
author2Str	Snijders, H. S. Fiocco, M. van Leersum, N. J. Kolfschoten, N. E. Wiggers, Th Wouters, M. W. J. M. Tollenaar, R. A. E. M.
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hochschulschrift_bool	false
doi_str	10.1245/s10434-013-2896-7
up_date	2024-07-04T03:40:30.333Z
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Differences in mortality between hospitals may be explained by varying complication rates. A possible modifying factor may be the ability to let patients with a serious complication survive, referred to as failure to rescue (FTR). The purpose of this study was to evaluate how hospital performance on postoperative mortality is related to severe complications or to FTR and to explore the value of FTR in quality improvement programs. Methods All patients operated for colorectal cancer from 2009 to 2011, registered in the Dutch Surgical Colorectal Audit, were included. Logistic regression models were used to obtain adjusted mortality, complication, and FTR rates. Hospitals were grouped into 5 quintiles according to adjusted mortality. Outcomes were compared between quintiles. Results A total of 24,667 patients were included. Severe complications ranged from 19 % in the lowest to 25 % in the highest mortality quintile (odds ratio 1.5, 95 % confidence interval 1.37–1.67). 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