FRIDAY, April 15 (HealthDay News) -- Thirty-day postoperative mortality following major colorectal cancer surgery varies significantly between hospitals, according to a study published online April 12 in Gut.
Eva J.A. Morris, Ph.D., from the University of Leeds in the United Kingdom, and colleagues assessed the variation in risk-adjusted 30-day postoperative mortality between hospital trusts within the English National Health Service for 160,920 patients diagnosed with colorectal cancer between 1998 and 2006. All patients underwent major resection for colorectal cancer, and national patterns and factors associated with death within 30 days of surgery were evaluated.
The investigators found that overall 30-day mortality was 6.7 percent, which decreased from 6.8 percent in 1998 to 5.8 percent in 2006, with the biggest decrease in 2005 and 2006. Increased postoperative mortality was associated with age (15.0 percent for patients older than 80 years), stage of disease (9.9 percent for Dukes' D disease), emergency resection (14.9 percent), comorbidity (24.2 percent for Charlson comorbidity score greater than or equal to three), and socioeconomic deprivation (7.8 percent for the most deprived). One of the hospital trusts consistently showed significantly improved risk-adjusted outcomes, and three of the hospital trusts had significantly worse outcomes compared to the population mean.
"Understanding the underlying causes that have led to the significant variation in 30-day postoperative mortality rates between surgical providers will make it possible to identify and spread best practice, improve outcomes, and, ultimately, reduce postoperative mortality following colorectal cancer surgery," the authors write.