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Differences in reported esophageal cancer resection outcomes between national clinical and administrative databases
Ist Teil von
The Journal of thoracic and cardiovascular surgery, 2012-11, Vol.144 (5), p.1152-1159
Ort / Verlag
New York, NY: Mosby, Inc
Erscheinungsjahr
2012
Quelle
MEDLINE
Beschreibungen/Notizen
Background The Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTSD) is the largest clinical thoracic surgical database in the United States. The purpose of the present study was to determine whether the GTSD esophagectomy outcomes are representative of nationwide outcomes by comparing them with other national clinical and administrative databases. Methods From 2002 to 2008, esophageal cancer resection outcomes from the GTSD were compared with those from the National Surgery Quality Improvement Program (NSQIP) and Nationwide Inpatient Sample (NIS). The observed differences in patient characteristics and postoperative events were also analyzed. Results Annual esophageal resection volumes have increased over time. However, as of 2008, the GTSD and NSQIP only capture a small proportion of resections performed nationally (36% and 11%, respectively). The median patient age and female gender were similar in all 3 databases. Mortality was significantly lower within the GTSD (3.2%) and NSQIP (2.6%) compared with the NIS (6.1%, P < .001). The median length of stay was lower in the GTSD (10 days) than in either the NSQIP (12 days) and NIS (12 days, P < .001). Conclusions The STS GTSD reports outstanding mortality results and hospital length of stay for esophageal cancer resection. However, the surgical outcomes from the STS GTSD are not representative of the national results from programs not participating in the database. These results establish a reference for future esophagectomy comparisons and highlight the importance of increased participation and use of the STS GTSD.