Establishment of quality of care among hospitals in digestive surgery

Not Applicable

• Conditions: Patients who underwent elective digestive surgery

• Registration Number: JPRN-UMIN000001410
• Lead Sponsor: ational Hospital Organization Kumamoto Medical Center

Brief Summary

I. Results for short-term outcomes In this study, we compared our prediction model E-PASS and its modified form mE-PASS with Western models, American Society of Anesthesiologists (ASA) status-based model and Portsmouth modification of Physiologic and Operative Severity Score for the enUmeration of Mortality and morbidity (P-POSSUM) in elective gastrointestinal surgery. The area under the receiver operative characteristic curve (AUC, 95% CI) values were 0.86 (0.79-0.93) for E-PASS, 0.86 (0.79-0.92) for mE-PASS, 0.81 (0.75-0.88) for P-POSSUM and 0.73 (0.63-0.83) for the ASA status-based model. Subsequently, we quantified the ratio of observed- to-estimated in-hospital mortality rates (OE ratio) as a measure of quality. The OE ratios for mE-PASS among large volume hospitals significantly correlated with those for other existing models. II. Results for long-term outcome gastric cancer resection We generated a model to predict overall survival (OS) using Cox hazard regression analysis in gastric cancer resection. This model exhibited a better discrimination power (AUC, 95% CI: 0.89, 0.86-0.91) than that for the UICC stage (0.81, 0.77-0.84). Subsequently, we quantified the OE ratio of 5-year OS rates as a measure of quality. The OE ratios among the participating hospitals revealed no significant variation between 0.74 and 1.1. III. Results for long-term outcome colorectal cancer resection We generated a model to predict OS using Cox hazard regression analysis in colorectal cancer resection. This model exhibited a better discrimination power (AUC, 95% CI: 0.87, 0.85-0.90) than that for the UICC stage (0.80, 0.76-0.83). Subsequently, we quantified the OE ratio of 5-year OS rates as a measure of quality. The OE ratios among the participating hospitals revealed no significant variation between 0.90 and 1.1.

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2008-10-02
• Study Completion: 2012-04-16
• Last Update Posted: 17 October 2023

Recruitment & Eligibility

• Status: Complete: follow-up complete
• Sex: All
• Target Recruitment: 5000

Inclusion Criteria

Not provided

Exclusion Criteria

1) Patients who refused to join this study 2) Patients who have concomitant malignant tumors of multiple organs 3) Patients who had malignant tumors within past 5 years

Study & Design

• Study Type: Observational
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
90-day mortality rate

Secondary Outcome Measures

Name	Time	Method
2 year and 5 year overall survival rates