Trial reportAnnals of surgical oncology2014
Hospital and geographic variability in two colorectal cancer surgery outcomes: complications and mortality after complications.
Trial report in Annals of surgical oncology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Quality indicators in surgical oncology: systematic review of measures used to compare quality across hospitals.BJS open · 2024Pooled it
- Cross-classified multilevel models (CCMM) in health research: A systematic review of published empirical studies and recommendations for best practices.SSM - population health · 2020Review
- Inter-country variability over time in the mortality of mechanically ventilated patients.Intensive care medicine · 2020Article
- Multilevel analysis in rural cancer control: A conceptual framework and methodological implications.Preventive medicine · 2019Article
- Outcome of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Colorectal Cancer.Maedica · 2019Article
- Improved perioperative care is associated with improved long-term survival in colorectal cancer.International journal of colorectal disease · 2018Article
- Validity of the CR-POSSUM model in surgery for colorectal cancer in Spain (CCR-CARESS study) and comparison with other models to predict operative mortality.BMC health services research · 2018Article
- Patient, Hospital, and Geographic Disparities in Laparoscopic Surgery Use Among Surveillance, Epidemiology, and End Results-Medicare Patients With Colon Cancer.Diseases of the colon and rectum · 2017Observational
- Short-term outcome in patients treated with cytoreduction and HIPEC compared to conventional colon cancer surgery.Medicine · 2016Observational
- Outcomes of support rod usage in loop stoma formation.International journal of colorectal disease · 2016Observational
- Nationwide variation in outcomes and cost of laparoscopic procedures.Surgical endoscopy · 2016Article
- The prediction accuracy of dynamic mixed-effects models in clustered data.BioData mining · 2016Article
- Patient, hospital, and geographic disparities associated with comanagement during hospitalization for colorectal cancer surgery.Journal of hospital medicine · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundThe purpose of this study was to describe hospital and geographic variation in 30-day risk of surgical complications and death among colorectal cancer (CRC) patients and the extent to which patient-, hospital-, and census-tract-level characteristics increased risk of these outcomes.
methodsWe included patients at least 66 years old with first primary stage I-III CRC from the 2000-2005 National Cancer Institute's Surveillance, Epidemiology, and End Results data linked with 1999-2005 Medicare claims. A multilevel, cross-classified logistic model was used to account for nesting of patients within hospitals and within residential census tracts. Outcomes were risk of complications and death after a complication within 30 days of surgery.
resultsData were analyzed for 35,946 patients undergoing surgery at 1,222 hospitals and residing in 12,187 census tracts; 27.2 % of patients developed complications, and of these 13.4 % died. Risk-adjusted variability in complications across hospitals and census tracts was similar. Variability in mortality was larger than variability in complications, across hospitals and across census tracts. Specific characteristics increased risk of complications (e.g., census-tract-poverty rate, emergency surgery, and being African-American). No hospital characteristics increased complication risk. Specific characteristics increased risk of death (e.g. census-tract-poverty rate, being diagnosed with colon (versus rectal) cancer, and emergency surgery), while hospitals with at least 500 beds showed reduced death risk.
conclusionsLarge, unexplained variations exist in mortality after surgical complications in CRC across hospitals and geographic areas. The potential exists for quality improvement efforts targeted at the hospital and/or census-tract levels to prevent complications and augment hospitals' ability to reduce mortality risk.
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