Objective
To assess the impact of American College of Surgeons National Surgical Quality Improvement
Program (ACS NSQIP) participation on outcomes in gastrointestinal surgical oncology.
Study design
A total of 6,076 resections for esophageal, gastric, pancreatic, hepatobiliary, and
colorectal cancers at 316 hospitals from the 2006 to 2011 ACS NSQIP were examined.
Thirty-day complication rates were analyzed longitudinally over time with the use
of multiple regression; we adjusted for operation type and preoperative risk factors.
Results
The procedure mix was 3% esophagectomy, 5% gastrectomy, 16% pancreatectomy, 4% hepatectomy,
63% colectomy, and 9% proctectomy. Median age was 66 years, and 52% were male, 41%
were American Society of Anesthesiologists class 2, and 52% were American Society
of Anesthesiologists 3. Depending on anatomic surgical site, 21–45% of patients experienced
a postoperative complication and 1.1–4.4% died. The incidence of patients with any
complication decreased from 28 to 24% over the period (risk-adjusted odds ratio 0.95
per year, 95% confidence interval 0.94–0.96). In contrast, there was no substantial
change in risk-adjusted mortality over the period (odds ratio 1.03, 95% confidence
interval 0.99–1.07).
Conclusion
There was a decrease in complications over time for ACS NSQIP participants in gastrointestinal
surgical oncology, but mortality did not decrease.
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Article info
Publication history
Published online: December 16, 2013
Accepted:
December 6,
2013
Footnotes
The views expressed in this paper are those of the authors and do not represent the official policy of the US Navy, Department of Defense, or US Government. The authors have no other sources of support or conflicts to report.
Identification
Copyright
© 2014 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
