Ninety-day Postoperative Mortality Is a Legitimate Measure of Hepatopancreatobiliary Surgical Quality
OBJECTIVE:To investigate the legitimacy of 90-day mortality as a measure of hepatopancreatobiliary quality. BACKGROUND:The 90-day mortality rate has been increasingly but not universally reported after hepatopancreatobiliary surgery. The legitimacy of this definition as a measure of surgical quality...
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| Veröffentlicht in: | Annals of surgery 2015-12, Vol.262 (6), p.1071-1078 |
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| container_title | Annals of surgery |
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| creator | Mise, Yoshihiro Vauthey, Jean-Nicolas Zimmitti, Giuseppe Parker, Nathan H Conrad, Claudius Aloia, Thomas A Lee, Jeffrey E Fleming, Jason B Katz, Matthew Harold G |
| description | OBJECTIVE:To investigate the legitimacy of 90-day mortality as a measure of hepatopancreatobiliary quality.
BACKGROUND:The 90-day mortality rate has been increasingly but not universally reported after hepatopancreatobiliary surgery. The legitimacy of this definition as a measure of surgical quality has not been evaluated.
METHODS:We retrospectively reviewed the causes of all deaths that occurred within 365 postoperative days in patients undergoing hepatectomy (n = 2811) and/or pancreatectomy (n = 1092) from January 1997 to December 2012. The rates of surgery-related, disease-related, and overall mortality within 30 days, within 30 days or during the index hospitalization, within 90 days, and within 180 days after surgery were calculated.
RESULTS:Seventy-nine (3%) surgery-related deaths and 92 (3%) disease-related deaths occurred within 365 days after hepatectomy. Twenty (2%) surgery-related deaths and 112 (10%) disease-related deaths occurred within 365 days after pancreatectomy. The overall mortality rates at 99 and 118 days optimally reflected surgery-related mortality after hepatobiliary and pancreatic operations, respectively. The 90-day overall mortality rate was a less sensitive but equivalently specific measure of surgery-related death.
CONCLUSIONS AND RELEVANCE:The 99- and 118-day definitions of postoperative mortality optimally reflected surgery-related mortality after hepatobiliary and pancreatic operations, respectively. However, among commonly reported metrics, the 90-day overall mortality rate represents a legitimate measure of surgical quality. |
| doi_str_mv | 10.1097/SLA.0000000000001048 |
| format | Article |
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BACKGROUND:The 90-day mortality rate has been increasingly but not universally reported after hepatopancreatobiliary surgery. The legitimacy of this definition as a measure of surgical quality has not been evaluated.
METHODS:We retrospectively reviewed the causes of all deaths that occurred within 365 postoperative days in patients undergoing hepatectomy (n = 2811) and/or pancreatectomy (n = 1092) from January 1997 to December 2012. The rates of surgery-related, disease-related, and overall mortality within 30 days, within 30 days or during the index hospitalization, within 90 days, and within 180 days after surgery were calculated.
RESULTS:Seventy-nine (3%) surgery-related deaths and 92 (3%) disease-related deaths occurred within 365 days after hepatectomy. Twenty (2%) surgery-related deaths and 112 (10%) disease-related deaths occurred within 365 days after pancreatectomy. The overall mortality rates at 99 and 118 days optimally reflected surgery-related mortality after hepatobiliary and pancreatic operations, respectively. The 90-day overall mortality rate was a less sensitive but equivalently specific measure of surgery-related death.
CONCLUSIONS AND RELEVANCE:The 99- and 118-day definitions of postoperative mortality optimally reflected surgery-related mortality after hepatobiliary and pancreatic operations, respectively. However, among commonly reported metrics, the 90-day overall mortality rate represents a legitimate measure of surgical quality.</description><identifier>ISSN: 0003-4932</identifier><identifier>EISSN: 1528-1140</identifier><identifier>DOI: 10.1097/SLA.0000000000001048</identifier><identifier>PMID: 25590497</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cause of Death ; Child ; Child, Preschool ; Female ; Hepatectomy - mortality ; Hepatectomy - standards ; Hospital Mortality ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Pancreatectomy - mortality ; Pancreatectomy - standards ; Postoperative Complications - mortality ; Postoperative Period ; Quality Indicators, Health Care - statistics & numerical data ; Retrospective Studies ; Texas ; Young Adult</subject><ispartof>Annals of surgery, 2015-12, Vol.262 (6), p.1071-1078</ispartof><rights>Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5388-745105a3b6c1d4c41f23ab75789101188aead2bb5f929a94231f600d416207ac3</citedby><cites>FETCH-LOGICAL-c5388-745105a3b6c1d4c41f23ab75789101188aead2bb5f929a94231f600d416207ac3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25590497$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mise, Yoshihiro</creatorcontrib><creatorcontrib>Vauthey, Jean-Nicolas</creatorcontrib><creatorcontrib>Zimmitti, Giuseppe</creatorcontrib><creatorcontrib>Parker, Nathan H</creatorcontrib><creatorcontrib>Conrad, Claudius</creatorcontrib><creatorcontrib>Aloia, Thomas A</creatorcontrib><creatorcontrib>Lee, Jeffrey E</creatorcontrib><creatorcontrib>Fleming, Jason B</creatorcontrib><creatorcontrib>Katz, Matthew Harold G</creatorcontrib><title>Ninety-day Postoperative Mortality Is a Legitimate Measure of Hepatopancreatobiliary Surgical Quality</title><title>Annals of surgery</title><addtitle>Ann Surg</addtitle><description>OBJECTIVE:To investigate the legitimacy of 90-day mortality as a measure of hepatopancreatobiliary quality.
BACKGROUND:The 90-day mortality rate has been increasingly but not universally reported after hepatopancreatobiliary surgery. The legitimacy of this definition as a measure of surgical quality has not been evaluated.
METHODS:We retrospectively reviewed the causes of all deaths that occurred within 365 postoperative days in patients undergoing hepatectomy (n = 2811) and/or pancreatectomy (n = 1092) from January 1997 to December 2012. The rates of surgery-related, disease-related, and overall mortality within 30 days, within 30 days or during the index hospitalization, within 90 days, and within 180 days after surgery were calculated.
RESULTS:Seventy-nine (3%) surgery-related deaths and 92 (3%) disease-related deaths occurred within 365 days after hepatectomy. Twenty (2%) surgery-related deaths and 112 (10%) disease-related deaths occurred within 365 days after pancreatectomy. The overall mortality rates at 99 and 118 days optimally reflected surgery-related mortality after hepatobiliary and pancreatic operations, respectively. The 90-day overall mortality rate was a less sensitive but equivalently specific measure of surgery-related death.
CONCLUSIONS AND RELEVANCE:The 99- and 118-day definitions of postoperative mortality optimally reflected surgery-related mortality after hepatobiliary and pancreatic operations, respectively. However, among commonly reported metrics, the 90-day overall mortality rate represents a legitimate measure of surgical quality.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cause of Death</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Hepatectomy - mortality</subject><subject>Hepatectomy - standards</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pancreatectomy - mortality</subject><subject>Pancreatectomy - standards</subject><subject>Postoperative Complications - mortality</subject><subject>Postoperative Period</subject><subject>Quality Indicators, Health Care - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Texas</subject><subject>Young Adult</subject><issn>0003-4932</issn><issn>1528-1140</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1PGzEQhi1UBCHlH6DKx142-DNrHyNUSqTwJeh5Nbs7C26dbGp7i_bfYwitEIfOZUae531Hfgk54WzGmS1P71aLGXtXnCmzRyZcC1NwrtgnMsmvslBWikNyFOPPzCjDygNyKLS2TNlyQvDKbTCNRQsjvelj6rcYILk_SC_7kMC7NNJlpEBX-OCSW0PKG4Q4BKR9Ry9wC1kDmyZgHmrnHYSR3g3hwTXg6e3wavGZ7HfgIx6_9Sn5cf7t_uyiWF1_X54tVkWjpTFFqTRnGmQ9b3irGsU7IaEudWksZ5wbAwitqGvdWWHBKiF5N2esVXwuWAmNnJKvO99t6H8PGFO1drFB72GD_RArXkqhrZ1LlVG1Q5vQxxiwq7Yhfy-MFWfVS8BVDrj6GHCWfXm7MNRrbP-J_iaaAbMDnnqfMMRffnjCUD0i-PT4f-9ntOuHbw</recordid><startdate>201512</startdate><enddate>201512</enddate><creator>Mise, Yoshihiro</creator><creator>Vauthey, Jean-Nicolas</creator><creator>Zimmitti, Giuseppe</creator><creator>Parker, Nathan H</creator><creator>Conrad, Claudius</creator><creator>Aloia, Thomas A</creator><creator>Lee, Jeffrey E</creator><creator>Fleming, Jason B</creator><creator>Katz, Matthew Harold G</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201512</creationdate><title>Ninety-day Postoperative Mortality Is a Legitimate Measure of Hepatopancreatobiliary Surgical Quality</title><author>Mise, Yoshihiro ; Vauthey, Jean-Nicolas ; Zimmitti, Giuseppe ; Parker, Nathan H ; Conrad, Claudius ; Aloia, Thomas A ; Lee, Jeffrey E ; Fleming, Jason B ; Katz, Matthew Harold G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5388-745105a3b6c1d4c41f23ab75789101188aead2bb5f929a94231f600d416207ac3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cause of Death</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Hepatectomy - mortality</topic><topic>Hepatectomy - standards</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pancreatectomy - mortality</topic><topic>Pancreatectomy - standards</topic><topic>Postoperative Complications - mortality</topic><topic>Postoperative Period</topic><topic>Quality Indicators, Health Care - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Texas</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mise, Yoshihiro</creatorcontrib><creatorcontrib>Vauthey, Jean-Nicolas</creatorcontrib><creatorcontrib>Zimmitti, Giuseppe</creatorcontrib><creatorcontrib>Parker, Nathan H</creatorcontrib><creatorcontrib>Conrad, Claudius</creatorcontrib><creatorcontrib>Aloia, Thomas A</creatorcontrib><creatorcontrib>Lee, Jeffrey E</creatorcontrib><creatorcontrib>Fleming, Jason B</creatorcontrib><creatorcontrib>Katz, Matthew Harold G</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mise, Yoshihiro</au><au>Vauthey, Jean-Nicolas</au><au>Zimmitti, Giuseppe</au><au>Parker, Nathan H</au><au>Conrad, Claudius</au><au>Aloia, Thomas A</au><au>Lee, Jeffrey E</au><au>Fleming, Jason B</au><au>Katz, Matthew Harold G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ninety-day Postoperative Mortality Is a Legitimate Measure of Hepatopancreatobiliary Surgical Quality</atitle><jtitle>Annals of surgery</jtitle><addtitle>Ann Surg</addtitle><date>2015-12</date><risdate>2015</risdate><volume>262</volume><issue>6</issue><spage>1071</spage><epage>1078</epage><pages>1071-1078</pages><issn>0003-4932</issn><eissn>1528-1140</eissn><abstract>OBJECTIVE:To investigate the legitimacy of 90-day mortality as a measure of hepatopancreatobiliary quality.
BACKGROUND:The 90-day mortality rate has been increasingly but not universally reported after hepatopancreatobiliary surgery. The legitimacy of this definition as a measure of surgical quality has not been evaluated.
METHODS:We retrospectively reviewed the causes of all deaths that occurred within 365 postoperative days in patients undergoing hepatectomy (n = 2811) and/or pancreatectomy (n = 1092) from January 1997 to December 2012. The rates of surgery-related, disease-related, and overall mortality within 30 days, within 30 days or during the index hospitalization, within 90 days, and within 180 days after surgery were calculated.
RESULTS:Seventy-nine (3%) surgery-related deaths and 92 (3%) disease-related deaths occurred within 365 days after hepatectomy. Twenty (2%) surgery-related deaths and 112 (10%) disease-related deaths occurred within 365 days after pancreatectomy. The overall mortality rates at 99 and 118 days optimally reflected surgery-related mortality after hepatobiliary and pancreatic operations, respectively. The 90-day overall mortality rate was a less sensitive but equivalently specific measure of surgery-related death.
CONCLUSIONS AND RELEVANCE:The 99- and 118-day definitions of postoperative mortality optimally reflected surgery-related mortality after hepatobiliary and pancreatic operations, respectively. However, among commonly reported metrics, the 90-day overall mortality rate represents a legitimate measure of surgical quality.</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>25590497</pmid><doi>10.1097/SLA.0000000000001048</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Cause of Death Child Child, Preschool Female Hepatectomy - mortality Hepatectomy - standards Hospital Mortality Humans Kaplan-Meier Estimate Male Middle Aged Pancreatectomy - mortality Pancreatectomy - standards Postoperative Complications - mortality Postoperative Period Quality Indicators, Health Care - statistics & numerical data Retrospective Studies Texas Young Adult |
| title | Ninety-day Postoperative Mortality Is a Legitimate Measure of Hepatopancreatobiliary Surgical Quality |
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