ArticleJAMA surgery2015
Lung Cancer Resection at Hospitals With High vs Low Mortality Rates.
Article in JAMA surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Failure to Rescue and Lung Resections for Lung Cancer: Measuring Quality from the Operation Room to the Intensive Care Unit.Cancers · 2025Review
- Comparison of failure to rescue in younger versus elderly patients following lung cancer resection.JTCVS open · 2023Article
- Surgeon Quality and Patient Survival After Resection for Non-Small-Cell Lung Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Article
- Changes in failure to rescue after gastrectomy at a large-volume center with a 16-year experience in Korea.Scientific reports · 2023Article
- Failure to rescue following anatomical lung resection. Analysis of a prospective nationwide database.Frontiers in surgery · 2023Article
- Knockdown ofAnnals of translational medicine · 2020Article
- Risk-Adjusted Margin Positivity Rate as a Surgical Quality Metric for Non-Small Cell Lung Cancer.The Annals of thoracic surgery · 2017Article
- Prognostic Value of National Comprehensive Cancer Network Lung Cancer Resection Quality Criteria.The Annals of thoracic surgery · 2017Observational
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5 authors.
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Abstract
importanceWide variations in mortality rates exist across hospitals following lung cancer resection; however, the factors underlying these differences remain unclear.
objectiveTo evaluate perioperative outcomes in patients who underwent lung cancer resection at hospitals with very high and very low mortality rates (high-mortality hospitals [HMHs] and low-mortality hospitals [LMHs]) to better understand the factors related to differences in mortality rates after lung cancer resection. DESIGN, SETTING, AND
participantsIn this retrospective cohort study, 1279 hospitals that were accredited by the Commission on Cancer were ranked on a composite measure of risk-adjusted mortality following major cancer resections performed from January 1, 2005, through December 31, 2006. We collected data from January 1, 2006, through December 31, 2007, on 645 lung resections in 18 LMHs and 25 HMHs. After adjusting for patient characteristics, we used hierarchical logistic regression to examine differences in the incidence of complications and "failure-to-rescue" rates (defined as death following a complication). MAIN OUTCOMES AND MEASURES: Rates of adherence to processes of care, incidence of complications, and failure to rescue following complications.
resultsAmong 645 patients who received lung resections (441 in LMHs and 204 in HMHs), the overall unadjusted mortality rates were 1.6% (n = 7) vs 10.8% (n = 22; P < .001) for LMHs and HMHs, respectively. Following risk adjustment, the difference in mortality rates was attenuated (1.8% vs 8.1%; P < .001) but remained significant. Overall, complication rates were higher in HMHs (23.3% vs 15.6%; adjusted odds ratio [aOR], 1.79; 95% CI, 0.99-3.21), but this difference was not significant. The likelihood of any surgical (aOR, 0.73; 95% CI, 0.26-2.00) or cardiopulmonary (aOR, 1.23; 95% CI, 0.70-2.16) complications was similar between LMHs and HMHs. However, failure-to-rescue rates were significantly higher in HMHs (25.9% vs 8.7%; aOR, 6.55; 95% CI, 1.44-29.88). CONCLUSIONS AND RELEVANCE: Failure-to-rescue rates are higher at HMHs, which may explain the large differences between hospitals in mortality rates following lung cancer resection. This finding emphasizes the need for better understanding of the factors related to complications and their subsequent management.
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