Nationwide prospective audit of pancreatic surgery : design, accuracy, and outcomes of the Dutch Pancreatic Cancer Audit
(2017) In HPB 19(10). p.919-926- Abstract
BACKGROUND: Auditing is an important tool to identify practice variation and 'best practices'. The Dutch Pancreatic Cancer Audit is mandatory in all 18 Dutch centers for pancreatic surgery.
METHODS: Performance indicators and case-mix factors were identified by a PubMed search for randomized controlled trials (RCT's) and large series in pancreatic surgery. In addition, data dictionaries of two national audits, three institutional databases, and the Dutch national cancer registry were evaluated. Morbidity, mortality, and length of stay were analyzed of all pancreatic resections registered during the first two audit years. Case ascertainment was cross-checked with the Dutch healthcare inspectorate and key-variables validated in all... (More)
BACKGROUND: Auditing is an important tool to identify practice variation and 'best practices'. The Dutch Pancreatic Cancer Audit is mandatory in all 18 Dutch centers for pancreatic surgery.
METHODS: Performance indicators and case-mix factors were identified by a PubMed search for randomized controlled trials (RCT's) and large series in pancreatic surgery. In addition, data dictionaries of two national audits, three institutional databases, and the Dutch national cancer registry were evaluated. Morbidity, mortality, and length of stay were analyzed of all pancreatic resections registered during the first two audit years. Case ascertainment was cross-checked with the Dutch healthcare inspectorate and key-variables validated in all centers.
RESULTS: Sixteen RCT's and three large series were found. Sixteen indicators and 20 case-mix factors were included in the audit. During 2014-2015, 1785 pancreatic resections were registered including 1345 pancreatoduodenectomies. Overall in-hospital mortality was 3.6%. Following pancreatoduodenectomy, mortality was 4.1%, Clavien-Dindo grade ≥ III morbidity was 29.9%, median (IQR) length of stay 12 (9-18) days, and readmission rate 16.0%. In total 97.2% of >40,000 variables validated were consistent with the medical charts.
CONCLUSIONS: The Dutch Pancreatic Cancer Audit, with high quality data, reports good outcomes of pancreatic surgery on a national level.
(Less)
- author
- contributor
- Tingstedt, Bobby LU
- author collaboration
- publishing date
- 2017-10
- type
- Contribution to journal
- publication status
- published
- keywords
- Aged, Databases, Factual, Female, Hospital Mortality, Humans, Length of Stay, Male, Medical Audit, Middle Aged, Netherlands, Pancreatectomy/adverse effects, Pancreaticoduodenectomy/adverse effects, Patient Readmission, Postoperative Complications/etiology, Process Assessment, Health Care/standards, Prospective Studies, Quality Indicators, Health Care/standards, Registries, Research Design, Risk Factors, Time Factors, Treatment Outcome
- in
- HPB
- volume
- 19
- issue
- 10
- pages
- 8 pages
- publisher
- Elsevier
- external identifiers
-
- scopus:85025826898
- pmid:28754367
- ISSN
- 1477-2574
- DOI
- 10.1016/j.hpb.2017.06.010
- language
- English
- LU publication?
- no
- additional info
- Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.
- id
- e7bcca8c-91f4-4322-ba35-4ed1a0b8f9bb
- date added to LUP
- 2024-09-30 13:07:28
- date last changed
- 2024-10-01 11:47:47
@article{e7bcca8c-91f4-4322-ba35-4ed1a0b8f9bb,
abstract = {{<p>BACKGROUND: Auditing is an important tool to identify practice variation and 'best practices'. The Dutch Pancreatic Cancer Audit is mandatory in all 18 Dutch centers for pancreatic surgery.</p><p>METHODS: Performance indicators and case-mix factors were identified by a PubMed search for randomized controlled trials (RCT's) and large series in pancreatic surgery. In addition, data dictionaries of two national audits, three institutional databases, and the Dutch national cancer registry were evaluated. Morbidity, mortality, and length of stay were analyzed of all pancreatic resections registered during the first two audit years. Case ascertainment was cross-checked with the Dutch healthcare inspectorate and key-variables validated in all centers.</p><p>RESULTS: Sixteen RCT's and three large series were found. Sixteen indicators and 20 case-mix factors were included in the audit. During 2014-2015, 1785 pancreatic resections were registered including 1345 pancreatoduodenectomies. Overall in-hospital mortality was 3.6%. Following pancreatoduodenectomy, mortality was 4.1%, Clavien-Dindo grade ≥ III morbidity was 29.9%, median (IQR) length of stay 12 (9-18) days, and readmission rate 16.0%. In total 97.2% of >40,000 variables validated were consistent with the medical charts.</p><p>CONCLUSIONS: The Dutch Pancreatic Cancer Audit, with high quality data, reports good outcomes of pancreatic surgery on a national level.</p>}},
author = {{van Rijssen, L Bengt and Koerkamp, Bas G and Zwart, Maurice J and Bonsing, Bert A and Bosscha, Koop and van Dam, Ronald M and van Eijck, Casper H and Gerhards, Michael F and van der Harst, Erwin and de Hingh, Ignace H and de Jong, Koert P and Kazemier, Geert and Klaase, Joost and van Laarhoven, Cornelis J and Molenaar, I Quintus and Patijn, Gijs A and Rupert, Coen G and van Santvoort, Hjalmar C and Scheepers, Joris J and van der Schelling, George P and Busch, Olivier R and Besselink, Marc G}},
issn = {{1477-2574}},
keywords = {{Aged; Databases, Factual; Female; Hospital Mortality; Humans; Length of Stay; Male; Medical Audit; Middle Aged; Netherlands; Pancreatectomy/adverse effects; Pancreaticoduodenectomy/adverse effects; Patient Readmission; Postoperative Complications/etiology; Process Assessment, Health Care/standards; Prospective Studies; Quality Indicators, Health Care/standards; Registries; Research Design; Risk Factors; Time Factors; Treatment Outcome}},
language = {{eng}},
number = {{10}},
pages = {{919--926}},
publisher = {{Elsevier}},
series = {{HPB}},
title = {{Nationwide prospective audit of pancreatic surgery : design, accuracy, and outcomes of the Dutch Pancreatic Cancer Audit}},
url = {{http://dx.doi.org/10.1016/j.hpb.2017.06.010}},
doi = {{10.1016/j.hpb.2017.06.010}},
volume = {{19}},
year = {{2017}},
}