TY - JOUR
T1 - Nationwide prospective audit of pancreatic surgery
T2 - design, accuracy, and outcomes of the Dutch Pancreatic Cancer Audit
AU - van Rijssen, L. Bengt
AU - Koerkamp, Bas G.
AU - Zwart, Maurice J.
AU - Bonsing, Bert A.
AU - Bosscha, Koop
AU - van Dam, Ronald M.
AU - van Eijck, Casper H.
AU - Gerhards, Michael F.
AU - van der Harst, Erwin
AU - de Hingh, Ignace H.
AU - de Jong, Koert P.
AU - Kazemier, Geert
AU - Klaase, Joost
AU - van Laarhoven, Cornelis J.
AU - Molenaar, I. Quintus
AU - Patijn, Gijs A.
AU - Rupert, Coen G.
AU - van Santvoort, Hjalmar C.
AU - Scheepers, Joris J.
AU - van der Schelling, George P.
AU - Busch, Olivier R.
AU - Besselink, Marc G.
AU - Dutch Pancreatic Canc Grp
PY - 2017/10
Y1 - 2017/10
N2 - 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.
AB - 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.
KW - PROSPECTIVE-RANDOMIZED-TRIAL
KW - INTERNATIONAL STUDY-GROUP
KW - LENGTH-OF-STAY
KW - CONTROLLED MULTICENTER TRIAL
KW - QUALITY IMPROVEMENT PROGRAM
KW - HOSPITAL MORTALITY
KW - ACS-NSQIP
KW - SURGICAL QUALITY
KW - ISGPS DEFINITION
KW - RISK CALCULATOR
U2 - 10.1016/j.hpb.2017.06.010
DO - 10.1016/j.hpb.2017.06.010
M3 - Article
C2 - 28754367
SN - 1365-182X
VL - 19
SP - 919
EP - 926
JO - HPB
JF - HPB
IS - 10
ER -