miércoles, 29 de noviembre de 2017

Colorectal cancer: Quality of surgical care in Michigan. - PubMed - NCBI

Colorectal cancer: Quality of surgical care in Michigan. - PubMed - NCBI





 2017 Mar;213(3):548-552. doi: 10.1016/j.amjsurg.2016.11.038. Epub 2016 Nov 27.

Colorectal cancer: Quality of surgical care in Michigan.

Abstract

OBJECTIVE:

Surgery remains the cornerstone therapy for colorectal cancer (CRC). This study assesses CRC quality measures for surgical cases in Michigan.

METHODS:

In this retrospective cohort study, processes of care and outcomes for CRC resection cases were abstracted in 30 hospitals in the Michigan Surgical Quality Collaborative (2014-2015). Measures were case-mix and reliability adjusted, using logistic regression models.

RESULTS:

For 871 cases (640 colon cancer, 231 rectal cancer), adjusted morbidity (27.4%) and mortality rates (1.5%) were low. Adjusted process measures showed gaps in quality of care. Mesorectal excision was documented in 59.4% of rectal cancer (RC) cases, 65% of RC cases had sphincter preserving surgery, 18.7% of cases had < 12 lymph nodes examined, 7.9% had a positive margin, 52.1% of stage II/III RC cases had neoadjuvant therapy, and 36% of ostomy cases had site marking.

CONCLUSION:

This study finds gaps in quality of care measures for CRC, suggesting opportunity for regional quality improvement.

KEYWORDS:

Colorectal cancer; Michigan Surgical Quality Collaborative (MSQC); Outcome assessment; Process measures; Quality improvement

PMID:
 
27939006
 
PMCID:
 
PMC5346056
 [Available on 2018-03-01]
 
DOI:
 
10.1016/j.amjsurg.2016.11.038

[Indexed for MEDLINE]

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