Evidence map›Paper›PMID 33677517›Full record

Observational studyInternational journal for quality in health care : journal of the International Society for Quality in Health Care2021

Differences in organization of care are associated with mortality, severe complication and failure to rescue in emergency colon cancer surgery.

Daniëlle D Huijts, Jan Willem T Dekker, Leti van Bodegom-Vos, Julia T van Groningen, Esther Bastiaannet, Perla J Marang-van de Mheen

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in International journal for quality in health care : journal of the International Society for Quality in Health Care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 8 citations in OpenAlex.

  1. Availability in ECMO Reduces the Failure to Rescue in Patients With Pulmonary Embolism After Major Surgery: A Nationwide Analysis of 2.4 Million Cases.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024
    Article
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Daniëlle D HuijtsDepartment of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Center, Albinusdreef 2, Leiden 2333 ZA, The Netherlands.
Jan Willem T DekkerDepartment of Surgery, Reinier de Graaf Group, Reinier de Graafweg 5, Delft 2600 GA, The Netherlands.
Leti van Bodegom-VosDepartment of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Center, Albinusdreef 2, Leiden 2333 ZA, The Netherlands.
Julia T van GroningenDutch Institute for Clinical Auditing, Rijnsburgerweg 10, Leiden 2333 ZA, The Netherlands.
Esther BastiaannetDepartment of Surgery, Leiden University Medical Center, Albinusdreef 2, Leiden 2333 ZA, The Netherlands.
Perla J Marang-van de MheenDepartment of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Center, Albinusdreef 2, Leiden 2333 ZA, The Netherlands.
Leiden University Medical Center · NLReinier de Graaf Hospital · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEmergency colon cancer surgery is associated with increased mortality and complication risk, which can be due to differences in the organization of hospital care. This study aimed.

objectiveTo explore which structural factors in the preoperative, perioperative and postoperative periods influence outcomes after emergency colon cancer surgery.

methodsAn observational study was performed in 30 Dutch hospitals. Medical records from 1738 patients operated in the period 2012 till 2015 were reviewed on the type of referral, intensive care unit (ICU) level, surgeon specialization and experience, duration of surgery and operating room time, blood loss, stay on specialized postoperative ward, complication occurrence, reintervention and day of surgery and linked to case-mix data available in the Dutch Colorectal Audit. Multivariate logistic regression analysis was used to estimate the influence of these factors on 30-day mortality, severe complication and failure to rescue (FTR), after adjustment for case-mix.

resultsPatients operated by a non-Gastro intestinal/oncology specialized surgeon have significantly increased mortality (Odds Ratio (OR) 2.28 [95% confidence interval (95% CI) 1.23-4.23]) and severe complication risk (OR 1.61 [95% CI 1.08-2.39]). Also, duration of stay in the operating room was significantly associated with increased risk on severe complication (OR 1.03 [95% CI 1.01-1.06]). Patients admitted to a non-specialized ward have significantly increased mortality (OR 2.25 [95% CI 1.46-3.47]) and FTR risk (OR 2.39 [95% CI 1.52-3.75]). A low ICU level (basic ICU) was associated with a lower severe complication risk (OR 0.72 [95% CI 0.52-1.00]). Surgery on Tuesday was associated with a higher mortality risk (OR 2.82 [95% CI 1.24-6.40]) and a severe complication risk (OR 1.77, [95% CI 1.19-2.65]).

conclusionThis study identified a non-specialized surgeon and ward, operating room, time and day of surgery to be risk factors for worse outcomes in emergency colon cancer surgery.

Indexed as

Colonic NeoplasmsHospitalizationHospital MortalityFemaleHospitalsHumansIntensive Care UnitsMalePostoperative ComplicationsRisk Factorscolon cancer surgeryquality of carerisk factors

Identifiers

PMID33677517
PMCPMC7948387
OpenAlexW3135124445

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.