A stratified analysis of the perioperative outcome of 17623 patients undergoing major head and neck cancer surgery in England over 10 years: Towards an Informatics‐based Outcomes Surveillance Framework

Abstract

Mortality following head and neck cancer surgery shows variation across different resection strata. We propose an Informatics-based Framework for Outcomes Surveillance (IFOS) in Head and Neck Surgery for perpetual quality assurance, using the local hospital coding data or its collated destination, the national administrative dataset.

Developing a risk stratification tool for audit of outcome after surgery for head and neck squamous cell carcinoma

“…Deriving true complication rates from coding data was validated in 2 departmental audits representing less than 3% of their published dataset. Caution will remain around the benchmarking process while data accuracy issues that feed into accuracy of statistical models are unresolved …”

Impact of social deprivation on the outcome of major head and neck cancer surgery in England: A national analysis

“…25 International classification of diseases (ICD)-10 codes and English National Health Service Office of Population and Censuses and Surveys (OPCS) codes were used to interrogate the Hospital Episodes Statistics (HES) dataset for HNC diagnoses, patient morbidities, surgical resection codes, complications, and finally outcomes. 25 International classification of diseases (ICD)-10 codes and English National Health Service Office of Population and Censuses and Surveys (OPCS) codes were used to interrogate the Hospital Episodes Statistics (HES) dataset for HNC diagnoses, patient morbidities, surgical resection codes, complications, and finally outcomes.…”

“…25 These were oral glossectomy, maxillectomy, oral vault excisions (RS1), pharyngeal glossectomy and palatal resections (RS2), floor-of-mouth resections and mandibulectomies (RS3), combined oral-pharyngeal resections (RS4), laryngectomy (RS5), and pharyngo-laryngectomy (RS6). 25 These were oral glossectomy, maxillectomy, oral vault excisions (RS1), pharyngeal glossectomy and palatal resections (RS2), floor-of-mouth resections and mandibulectomies (RS3), combined oral-pharyngeal resections (RS4), laryngectomy (RS5), and pharyngo-laryngectomy (RS6).…”

“…25 These were oral glossectomy, maxillectomy, oral vault excisions (RS1), pharyngeal glossectomy and palatal resections (RS2), floor-of-mouth resections and mandibulectomies (RS3), combined oral-pharyngeal resections (RS4), laryngectomy (RS5), and pharyngo-laryngectomy (RS6). FTRL thresholds for RS1-RS6 were 19,25,26,27,37, and 48 days, respectively. This was a measure introduced to specifically identify those who were seen to undergo unusually long hospital stays, that is, 75% of their comparable group.…”

“…25 Individual RS and data from LOS were used to calculate failure to rescue LOS (FTRL) threshold, referring to the 75th centile of LOS for each individual RS. 25 Effects of primary surgery vs emergency surgery were also measured. FTRL thresholds for RS1-RS6 were 19,25,26,27,37, and 48 days, respectively.…”