Standard outcome indicators after colon cancer resection. Creation of a nomogram for autoevaluation

Autores de IIS La Fe

• Jorge Sancho Muriel

  Autor

• 

  Matteo Frasson

  Autor

• David Hervás Marín

  Autor

• Blas Flor Lorente

  Autor

• Eduardo García-Granero Ximénez

  Autor

Participantes ajenos a IIS La Fe

• Ramos Rodriguez JL
• Romero Simó M
• Escoll Rufino J
• Santamaría Olabarrieta M
• Viñas Martinez J
• López Bañeres M
• ANACO Study Group

Grupos

• Cirugía digestiva y Cuidados perioperatorios

  

  Leader

  Matteo Frasson

Abstract

Introduction: Lately there has been an increasing interest in identifying quality standards in different pathologies, among them colon cancer due to its great prevalence. The main goal of this study is to define the quality standards of colon cancer surgery based on a large prospective national study dataset. Methods: Data from the prospective national study ANACO were used. This study included a consecutive series of patients operated on for colon cancer in 52 Spanish hospitals (20112012). Centers with less than 30 patients were excluded. The present analysis finally included 42 centers (2975 patients). Based on the results obtained in 4 main indicators from each hospital (anastomotic leak, lymph-nodes found in the specimen, mortality and length of stay), a nomogram that allows the evaluation of the performance of each center was designed. Standard results for further 5 intraoperative and 5 postoperative quality indicators were also reported. Results: Median of anastomotic leak and mortality rate was 8.5% (25th-75th percentiles 6.1%12.4%) and 2.5% (25th-75th percentiles 0.6%-4.7%), respectively. Median number of nodes found in the surgical specimen was 15,1 (25th-75th percentiles 18-14 nodes). Median length of postoperative stay was 7.7 days (25th-75th percentiles 6.9-9.2 days). Based on these data, a nomogram for hospital audit was created. Conclusions: Standard surgical results after colon cancer surgery were defined, creating a tool for auto-evaluation and allowing each center to identify areas for improvement in the surgical treatment of colon cancer. (C)2016 AEC. Published by Elsevier Espana, S.L.U. All rights reserved.

Keywords

• Colonic neoplasms; Colon surgery; Outcome assessment; Quality indicators; Reference standards