Variation in the quality of surgical care, especially for common illnesses like colorectal cancer, has received increasing attention.
Nonfatal complications resulting in procedural interventions are likely to play a role in poor outcomes but have not been well explored.
Dr Arden Morris and colleagues identified unplanned procedures following colorectal cancer surgery that might be used as intermediate outcome measures.
The researchers determined their association with mortality and length of stay.
|A total of 6% of patients required postoperative interventions|
|Annals of Surgery|
The team undertook a cohort analysis of 26,638 stage 1 to 3 colorectal cancer patients.
The patients were identified in the 1992 to 1996 Surveillance, Epidemiology, and End Results-Medicare database.
The researchers' independent variables included sociodemographics, tumor characteristics, comorbidity, and acuity.
The primary outcome was postoperative procedural intervention.
The team used logistic regression to identify patient characteristics predicting postoperative procedures, and the adjusted risk of 30-day mortality.
The researchers also evaluated prolonged hospitalization among patients with postoperative procedures.
The researchers observed a total of 6% of patients required postoperative interventions.
The team found that patient characteristics had little impact on the frequency of postoperative procedures, except for acute medical conditions.
The postoperative procedures included bowel perforation, obstruction,
and emergency admission.
The researchers noted that after a postoperative procedure, patients were more likely to experience early mortality, and prolonged hospitalization.
The most common interventions were performed for abdominal infection.
The team found that other common interventions performed were for wound complications, and organ injury.
Dr Morris' team commented, “Postoperative complications requiring additional procedures among colorectal cancer patients correlate with established measures of surgical quality.”
“Prospective tracking of postoperative procedures as complication markers may facilitate outcome studies, and quality improvement programs.”