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 19 April 2018

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News

Causes of high mortality in colorectal surgery

This month's American Journal of Surgery reviews causes of high mortality in colorectal surgery in Veterans Affairs hospitals.

News image

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Dr Kamal Itani and colleagues from Massachusetts, USA examined the episode of care for colorectal surgery.

The research team assessed 8 outlier Veterans Affairs Hospitals with high mortality, and the volume outcome relationship in 118 hospitals.

The team reviewed a total of 103 deaths.

The research team noted that the mean age was 74 with 63% of the patients undergoing emergency surgery.

The research team observed that 54% of the patients had malignant disease, and 21% had metastatic disease.

19% of the patients had a delay in diagnosis
The American Journal of Surgery

The team found that 19% of the patients had a delay in diagnosis, 22% had delay in surgery, and 14% should have received a different surgery usually less radical.

In addition, system related issues were identified in 19% of the cases, and practitioner related issues in 20% of the cases.

The research team found the Spearman rank correlation between colorectal surgery volume and unadjusted mortality was 0.11.

Dr Itani's team concluded, "Colorectal surgery death is prevalent in elderly patients undergoing emergency surgery for malignancy or metastatic disease, and is not related to hospital volume."

"Timely diagnosis, less radical surgery while optimizing system based pathways might improve outcome."

Am J Surg 2007: 194(5): 639-45
02 November 2007

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