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HPB (Oxford). 2017 Oct;19(10):919-926. doi: 10.1016/j.hpb.2017.06.010. Epub 2017 Jul 26.

Nationwide prospective audit of pancreatic surgery: design, accuracy, and outcomes of the Dutch Pancreatic Cancer Audit.

Author information

1
Department of Surgery, Academic Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands.
2
Department of Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
3
Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
4
Department of Surgery, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands.
5
Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
6
Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
7
Department of Surgery, Maasstad Hospital, Rotterdam, The Netherlands.
8
Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands.
9
Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.
10
Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands.
11
Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands.
12
Department of Surgery, Radboud University Medical Center, The Netherlands.
13
Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
14
Department of Surgery, Isala Clinics, Zwolle, The Netherlands.
15
Department of Surgery, Tjongerschans Hospital, Heerenveen, The Netherlands.
16
Department of Surgery, St Antonius Hospital, Nieuwegein, The Netherlands.
17
Department of Surgery, Reinier de Graaf Gasthuis, Delft, The Netherlands.
18
Department of Surgery, Amphia Hospital, Breda, The Netherlands.
19
Department of Surgery, Academic Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands. Electronic address: m.g.besselink@amc.nl.
20
Department of Radiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
21
Department of Gastroenterology, Erasmus Medical Center, Rotterdam, The Netherlands.
22
Department of Radiotherapy, Academic Medical Center, Amsterdam, The Netherlands.
23
Dordrecht, The Netherlands.
24
Leicester General Hospital, Leicester, UK.
25
Skåne University Hospital, Lund, Sweden.
26
Beth Israel Deaconess Medical Center, Boston, MA, USA.
27
The Johns Hopkins School of Medicine, Baltimore, MD, USA.

Abstract

BACKGROUND:

Auditing is an important tool to identify practice variation and 'best practices'. The Dutch Pancreatic Cancer Audit is mandatory in all 18 Dutch centers for pancreatic surgery.

METHODS:

Performance indicators and case-mix factors were identified by a PubMed search for randomized controlled trials (RCT's) and large series in pancreatic surgery. In addition, data dictionaries of two national audits, three institutional databases, and the Dutch national cancer registry were evaluated. Morbidity, mortality, and length of stay were analyzed of all pancreatic resections registered during the first two audit years. Case ascertainment was cross-checked with the Dutch healthcare inspectorate and key-variables validated in all centers.

RESULTS:

Sixteen RCT's and three large series were found. Sixteen indicators and 20 case-mix factors were included in the audit. During 2014-2015, 1785 pancreatic resections were registered including 1345 pancreatoduodenectomies. Overall in-hospital mortality was 3.6%. Following pancreatoduodenectomy, mortality was 4.1%, Clavien-Dindo grade ≥ III morbidity was 29.9%, median (IQR) length of stay 12 (9-18) days, and readmission rate 16.0%. In total 97.2% of >40,000 variables validated were consistent with the medical charts.

CONCLUSIONS:

The Dutch Pancreatic Cancer Audit, with high quality data, reports good outcomes of pancreatic surgery on a national level.

PMID:
28754367
DOI:
10.1016/j.hpb.2017.06.010
[Indexed for MEDLINE]
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