Weekend Effect in Emergency Colon and Rectal Cancer Surgery: A Prospective Study Using Data From the Dutch ColoRectal Audit

Huijts, Daniëlle D.; Groningen, Julia T. van; Guicherit, Onno R.; Dekker, Jan Willem T.; Bodegom‐Vos, Leti van; Bastiaannet, E.; Govaert, Johannes A.; Wouters, Michel W. J. M.; Mheen, P.J. Marang-van de

doi:10.6004/jnccn.2018.7016

Cited by 16 publications

(19 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Emergency surgery due to obstruction, perforation or bleeding has been shown to give inferior oncological results and life expectancy compared to planned surgery [28]. A contributing factor for this is that emergency surgery is often performed during afternoon/night shifts or weekends and by a high number of different surgeons, which has been shown to give inferior results [29]. The present study did not support this finding.…”

Section: Discussioncontrasting

confidence: 73%

Clinical Predictors for Reduced Long-Term Survival and Cause of Death after Curative Resection for Rectal Cancer

Røkke¹,

Heggelund²,

Benth³

et al. 2021

JCT

View full text Add to dashboard Cite

Purpose: To identify clinical predictors for reduced long-term survival and describe the cause of death after surgical treatment for rectal cancer. Methods: A retrospective follow-up study of 442 consecutive, unselected patients treated for rectal cancer at a tertiary centre from 1990 until 2000 and followed for 17 years or until death. Predictors for death were assessed by Cox regression analysis. The cause of death was obtained from the Norwegian Cause of Death Registry. Results: 254 men and 188 women with a median age of 71 years (21-95 years) were resected for rectal cancer with low anterior resection (n = 266), abdominoperineal resection (n = 125), Hartmann's procedure (n = 19) or diverting stoma only (n = 32). Median follow-up was 5 years (0-17 years). The relative five-year survival rates for stages I, II, III and IV was 83.9%, 65.2%, 41.1% and 9.3%, respectively. The proportion of deaths due to recurrence from colorectal cancer in stages I, II, III and IV was 23.5%, 55.8%, 72.3% and 98.0%, respectively. Heart, lung and cerebrovascular disease and other malignancies were the cause of death in the other patients. Higher age, abdominoperineal resection compared to low anterior resection, lack of lymph node dissection compared to total mesorectal excision (TME), postoperative reoperations, TNM stages II and III compared to stage I and residual tumours after surgery were all significant independent predictors of reduced survival in the adjusted Cox regression model. Conclusions: Age, tumour stage, type of surgery, lymph node dissection, residual tumour after surgery and reoperations are predictors for survival after surgery for rectal can

show abstract

Section: Discussioncontrasting

confidence: 73%

Clinical Predictors for Reduced Long-Term Survival and Cause of Death after Curative Resection for Rectal Cancer

Røkke¹,

Heggelund²,

Benth³

et al. 2021

JCT

View full text Add to dashboard Cite

show abstract

“…These are most likely explained by a small number of included cases. 4 These findings underline the need for the consideration of healthcare contexts in risk-adjusted quality assurance.…”

Section: Discussionmentioning

confidence: 92%

Relationships between multiple patient safety outcomes and healthcare and hospital-related risk factors in colorectal resection cases: cross-sectional evidence from a nationwide sample of 232 German hospitals

et al. 2022

View full text Add to dashboard Cite

ObjectivesStudies analysing colorectal resections usually focus on a specific outcome (eg, mortality) and/or specific risk factors at the individual (eg, comorbidities) or hospital (eg, volume) level. Comprehensive evidence across different patient safety outcomes, risk factors and patient groups is still scarce. Therefore the aim of this analysis was to investigate consistent relationships between multiple patient safety outcomes, healthcare and hospital risk factors in colorectal resection cases.DesignCross-sectional study.SettingGerman inpatient routine care data of colorectal resections between 2016 and 2018.ParticipantsWe analysed 54 168 colon resection and 20 395 rectum resection cases treated in German hospitals. The German Inpatient Quality Indicators were used to define colon resections and rectum resections transparently.Primary outcome measuresAdditionally to in-hospital death, postoperative respiratory failure, renal failure and postoperative wound infections we included multiple patient safety outcomes as primary outcomes/dependent variables for our analysis. Healthcare (eg, weekend surgery), hospital (eg, volume) and case (eg, age) characteristics served as independent covariates in a multilevel logistic regression model. The estimated regression coefficients were transferred into ORs.ResultsWeekend surgery, emergency admissions and transfers from other hospitals were significantly associated (ORs ranged from 1.1 to 2.6) with poor patient safety outcome (ie, death, renal failure, postoperative respiratory failure) in colon resections and rectum resections. Hospital characteristics showed heterogeneous effects. In colon resections hospital volume was associated with insignificant or adverse associations (postoperative wound infections: OR 1.168 (95% CI 1.030 to 1.325)) to multiple patient safety outcomes. In rectum resections hospital volume was protectively associated with death, renal failure and postoperative respiratory failure (ORs ranged from 0.7 to 0.8).ConclusionsTransfer from other hospital and emergency admission are constantly associated with poor patient safety outcome. Hospital variables like volume, ownership or localisation did not show consistent relationships to patient safety outcomes.Trial registration numberISRCTN10188560.

show abstract

“…During emergency surgery, the main focus is on saving the patient's life and having a short time in general anaesthesia, and there is less focus on, for example, extended lymph node dissection. More procedures are performed on nightshifts and weekends, which is associated with higher mortality and more severe complications [15]. During this period, emergency surgery in our institution was performed by many general surgeons, and even residents, not specialized in colorectal surgery, which has been shown to increase the rate of distant recurrences [16].…”

Section: Discussionmentioning

confidence: 99%

Cause of Death and Clinical Predictors of Survival after Curative Resection for Colon Cancer

Røkke¹,

Heggelund²,

Benth³

et al. 2021

JCT

View full text Add to dashboard Cite

Background: Clinical predictors of death and survival in surgical treatment of colon cancer are easily confounded by the modern adjuvant and neo-adjuvant chemotherapy. This study focuses on lethality and survival during implementation of ultra-radical surgery for colonic cancer prior to multimodal therapy. Methods: Retrospective observational follow-up study of 824 consecutive, unselected patients resected for Stage I, II, III and IV colon cancer from 1990 until 2000 at one tertiary centre, with a median follow-up of 45 months (0 -202 months). Predictors for death were assessed by Cox regression analyses and log-rank test. The cause of death was obtained from the Norwegian Cause of Death Registry. Results: The relative survival rates were 86.3%, 71.9%, 50.3% and 6.6% in Stage I, II, III and IV, respectively. In 28.7% of the patients, the cause of death was other than colorectal cancer recurrence. The adjusted Cox regression model showed that higher age ( 1.04 (95% CI: 1.03; 1.05)), male gender (1.37 (1.14; 1.66)), emergency surgery (1.52 (1.21; 1.93)), left vs. right hemicolectomy (1.39 (1.03; 1.87)), and perioperative blood transfusion (1.25 (1.01; 1.55)) were predictors of reduced survival. Health without known comorbidity (0.71 (0.58; 0.88)), D2 versus D1 lymph node dissection (0.66 (0.53; 0.83)) and tumour Stage I, II, III versus Stage IV 0.10 (0.06; 0.16), 0.14 (0.11; 0.19), 0.23 (0.18; 0.30) were associated with prolonged survival. Conclusions: In 28.7% of the patients, the cause of death was other than colorectal cancer recurrence. Age, sex, comorbidity, emergency resection, lack of lymph node dissection, tumour stage, and preoperative blood trans-

show abstract

Weekend Effect in Emergency Colon and Rectal Cancer Surgery: A Prospective Study Using Data From the Dutch ColoRectal Audit

Cited by 16 publications

References 14 publications

Clinical Predictors for Reduced Long-Term Survival and Cause of Death after Curative Resection for Rectal Cancer

Clinical Predictors for Reduced Long-Term Survival and Cause of Death after Curative Resection for Rectal Cancer

Relationships between multiple patient safety outcomes and healthcare and hospital-related risk factors in colorectal resection cases: cross-sectional evidence from a nationwide sample of 232 German hospitals

Cause of Death and Clinical Predictors of Survival after Curative Resection for Colon Cancer

Contact Info

Product

Resources

About