Validation of MTL30 as a quality indicator for colorectal surgery

Abstract

Background Valid indicators are required to measure surgical quality. These ideally should be sensitive and selective while being easy to understand and adjust. We propose here the MTL30 quality indicator which takes into account 30-day mortality, transfer within 30 days, and a length of stay of 30 days as composite markers of an uneventful operative/postoperative course. Methods Patients documented in the StuDoQ|Colon and StuDoQ|Rectal carcinoma register of the German Society for General and Visceral Surgery (DGAV) were analyzed with regard to the effects of patient and tumor-related risk factors as well as postoperative complications on the MTL30. Results In univariate analysis, the MTL30 correlated significantly with patient and tumor-related risk factors such as ASA score (p<0.001), age (p<0.001), or UICC stage (p<0.001). There was a high sensitivity for the postoperative occurrence of complications such as re-operations (p<0.001) or subsequent bleeding (p<0.001), as well as a significant correlation with the CDC classification (p<0.001). In multivariate analysis, patient-related risk factors and postoperative complications significantly increased the odds ratio for a positive MTL30. A negative MTL30 showed a high specify for an uneventful operative and postoperative course. Conclusion The MTL30 is a valid indicator of colorectal surgical quality.

Robotic-Assisted versus Laparoscopic Left Hemicolectomy—Postoperative Inflammation Status, Short-Term Outcome and Cost Effectiveness

“…The primary endpoint was defined as the length of hospital stay. Secondary endpoints were postoperative complications within 30 days, including MTL30 [ 9 ]. Furthermore, serum levels of leukocytes and C-reactive protein (CRP) were collected on postoperative days 1, 3 and 5.…”

Differences in morbidity and mortality between unilateral adrenalectomy for adrenal Cushing’s syndrome and bilateral adrenalectomy for therapy refractory extra-adrenal Cushing’s syndrome

“…The primary endpoint was the comprehensive complication index (CCI) [ 12 ]. Secondary endpoints were postoperative as well as long-term survival, and two combined clinical endpoints of postoperative outcomes: first, we used the MTL30, a validated marker in colorectal surgery, combining mortality, transfer to another acute care hospital, and length-of-stay (LOS) > 30 days [ 13 , 14 ]. Secondly, we defined delayed postoperative recovery as a comprehensive complication index (CCI) [ 12 ] > 20 points or a prolonged LOS (> 75% percentile, 11 days).…”

Potential considerations in decision making on laparoscopic colorectal resections in Hungary based on administrative data

“…To analyse output data clearly, it would be necessary to standardize surgical indication for LCR and OCR. The standardized procedure could help to establish indicators of colorectal surgical quality like MTL30 [ 28 ]. In our database it seems that women had slightly higher odds for laparoscopic colorectal resections (OR: 1.128; p = 0.004) than men.…”