Failure to rescue and pulmonary resection for lung cancer

Farjah, Farhood; Backhus, Leah M.; Cheng, Aaron M.; Englum, Brian R.; Kim, Sunghee; Saha-Chaudhuri, Paramita; Wood, Douglas E.; Mulligan, Michael S.; Varghese, Thomas K.

doi:10.1016/j.jtcvs.2015.01.063

Cited by 52 publications

(38 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The FTR rate has several potential advantages over more convention outcome metrics. While it has been repeatedly shown that center level SAE rates correlate poorly with center level mortality rates (4, 5), center level FTR rates are strongly associated with center level mortality across a wide variety of elective surgical populations (6–8). Moreover, relative to risk of SAE, risk of FTR is more strongly associated with potentially modifiable center level factors such as staffing patterns and infrastructure (9).…”

Section: Introductionmentioning

confidence: 99%

Age and preexisting conditions as risk factors for severe adverse events and failure to rescue after injury

Earl-Royal

Kaufman

Hsu

et al. 2016

Journal of Surgical Research

View full text Add to dashboard Cite

Introduction Failure to rescue (FTR: the conditional probability of death after complication) has been studied in trauma cohorts, but the impact of age and pre-existing conditions (PECs) on risk of FTR is not well-known. We assessed the relationship between age and PECs on the risk of experiencing serious adverse events (SAE) subsequent FTR in trauma patients with the hypothesis that increased comorbidity burden and age would be associated with increased FTR. Materials and Methods We performed a retrospective cohort analysis at an urban level 1 trauma center in PA. All patients age ≥ 16 years with minimum abbreviated injury scale score ≥ 2 from 2009–2013 were included. Univariate logistic regression models for SAE and FTR were developed using age, PECs, demographics, and injury physiology. Variables found to be associated with the endpoint of interest (p≤0.2) in univariate analysis were included in separate multivariable logistic regression models for each outcome. Results SAE occurred in 1,136/7533 (15.1 %) of patients meeting inclusion criteria (median age 42 (IQR 26–59), 53% African American, 72% male, 79% blunt, median ISS 10 (IQR 5–17)). Of those who experienced a SAE, 129/1136 patients subsequently died (FTR = 11.4%). Development of SAE and FTR was associated with age ≥ 70 (OR 1.58–1.78, 95% CI 1.13–2.82). Renal disease was the only pre-existing condition associated with both SAE and FTR. Conclusions Trauma patients with renal disease are most at increased risk for both SAE and FTR, but other PECs associated with SAE are not necessarily those associated with FTR. Future interventions designed to reduce FTR events should target this high-risk cohort.

show abstract

Section: Introductionmentioning

confidence: 99%

Age and preexisting conditions as risk factors for severe adverse events and failure to rescue after injury

Earl-Royal

Kaufman

Hsu

et al. 2016

Journal of Surgical Research

View full text Add to dashboard Cite

show abstract

“…Such gaps affect short-term outcomes, such as postoperative mortality and hospital readmission rates [7,8]. Gaps in the oncologic quality of resection may be more difficult to measure because of their delayed manifestation [9].…”

mentioning

confidence: 99%

Prognostic Value of National Comprehensive Cancer Network Lung Cancer Resection Quality Criteria

Osarogiagbon¹,

Ray

Faris³

et al. 2017

The Annals of Thoracic Surgery

View full text Add to dashboard Cite

Background The National Comprehensive Cancer Network (NCCN) surgical resection guidelines for non-small-cell lung cancer (NSCLC) recommend anatomic resection, negative margins, examination of hilar/intrapulmonary lymph nodes, and examination of 3 or more mediastinal nodal stations. We examined the survival impact of these guidelines. Methods Population-based observational study using patient-level data from all curative-intent NSCLC resections from 2004–2013 at 11 institutions in 4 contiguous Dartmouth Hospital Referral Regions in 3 US states. We used an adjusted Cox proportional hazards model to assess the overall survival impact of attaining NCCN guidelines. Results Of 2,429 eligible resections,91% were anatomic, 94% had negative margins, 51% sampled hilar nodes, and 26% examined three or more mediastinal nodal stations. Only 17% of resections met all four criteria, however there was a significant increasing trend from 2% in 2004 to 39% in 2013 (p<0.001). Compared to patients whose surgery missed one or more parameters, the hazard ratio for patients whose surgery met all four criteria was 0.71 (95% confidence interval: 0.59–0.86, p<0.001). Margin status and the nodal staging parameters were most strongly linked with survival. Conclusions Attainment of NCCN surgical quality guidelines was low, but improving, over the past decade in this cohort from a high lung cancer mortality region of the US. The NCCN quality criteria, especially the nodal examination criteria, were strongly associated with survival. The quality of nodal examination should be a focus of quality improvement in NSCLC care.

show abstract

“…FTR studies have been motivated by a surprising finding identified in numerous independent studies; specifically, investigators found that the complication rate between the best and worst hospitals differs only slightly, whereas FTR for the best centers is markedly better than the FTR of centers with poor performance [3][4][5][6][7][8]. FTR, then, appears to complement traditional approaches by focusing on an important aspect of care that has previously been a blind spot in objective quality measurement [3,[9][10][11][12][13].…”

mentioning

confidence: 99%

“…The focus in surgical studies has been on complications after an operative procedure. Some investigators have used an array of operations [7-9, 11, 12], whereas others have studied a single operation [3,14,15]. Likewise, some have examined a set of complications [7-9, 12, 14] rather than a single complication [16].…”

mentioning

confidence: 99%

Failure to Rescue Rates After Coronary Artery Bypass Grafting: An Analysis From The Society of Thoracic Surgeons Adult Cardiac Surgery Database

Edwards

Ferraris

Kurlansky

et al. 2016

The Annals of Thoracic Surgery

View full text Add to dashboard Cite

show abstract

Failure to rescue and pulmonary resection for lung cancer

Cited by 52 publications

References 31 publications

Age and preexisting conditions as risk factors for severe adverse events and failure to rescue after injury

Age and preexisting conditions as risk factors for severe adverse events and failure to rescue after injury

Prognostic Value of National Comprehensive Cancer Network Lung Cancer Resection Quality Criteria

Failure to Rescue Rates After Coronary Artery Bypass Grafting: An Analysis From The Society of Thoracic Surgeons Adult Cardiac Surgery Database

Contact Info

Product

Resources

About