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Addressing the Quality of Hospital Care of Colorectal Cancer Patients Undergoing Surgery: What Can We Learn From the National Bowel Cancer Audit?

Introduction The National Bowel Cancer Audit (NBOCA) is the largest database in the United Kingdom that audits real-world data and allows comparison of the quality of care for colorectal cancer patients. This study aimed to highlight relevant clinical factors in the NBOCA that contribute to variatio...

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Autores principales: Li, Chunhei, Ooi, Setthasorn Zhi Yang, Woo, Timothy, Chan, Hei Man Priscilla
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8938235/
https://www.ncbi.nlm.nih.gov/pubmed/35371786
http://dx.doi.org/10.7759/cureus.22333
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author Li, Chunhei
Ooi, Setthasorn Zhi Yang
Woo, Timothy
Chan, Hei Man Priscilla
author_facet Li, Chunhei
Ooi, Setthasorn Zhi Yang
Woo, Timothy
Chan, Hei Man Priscilla
author_sort Li, Chunhei
collection PubMed
description Introduction The National Bowel Cancer Audit (NBOCA) is the largest database in the United Kingdom that audits real-world data and allows comparison of the quality of care for colorectal cancer patients. This study aimed to highlight relevant clinical factors in the NBOCA that contribute to variation in the quality of care provided in different hospitals. Methods Data from 36,116 patients with colorectal cancer who had undergone surgery were obtained from the NBOCA. These were patients from 145 and 146 hospitals from the years 2016 and 2017, respectively. A validated multiple linear regression was performed to compare the identified clinical factors with various quality outcomes. The quality outcomes defined in this study were the length of hospital stay of more than five days, two-year mortality, 30-day unplanned readmission rate, 90-day mortality, and 18-month stoma rate. Results Four clinical factors (laparoscopy rate, abdominal-perineal-resection-of-rectum, pre-operative radiotherapy, and patients with distant metastases) were shown to have a significant (p < 0.05) impact on the length of hospital stay of more than five days and the 18-month stoma rate. The 18-month stoma rate was also a significant predictor (p < 0.001) with two-year mortality. Conclusion The NBOCA should consider adjusting for these factors when reporting the quality of care provided in hospitals. Hospitals should monitor the four clinical factors for colorectal cancer patients during perioperative care. When formulating a management plan for patients with colorectal cancer, clinicians should consider these factors along with the individual patient's history.
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spelling pubmed-89382352022-03-31 Addressing the Quality of Hospital Care of Colorectal Cancer Patients Undergoing Surgery: What Can We Learn From the National Bowel Cancer Audit? Li, Chunhei Ooi, Setthasorn Zhi Yang Woo, Timothy Chan, Hei Man Priscilla Cureus General Surgery Introduction The National Bowel Cancer Audit (NBOCA) is the largest database in the United Kingdom that audits real-world data and allows comparison of the quality of care for colorectal cancer patients. This study aimed to highlight relevant clinical factors in the NBOCA that contribute to variation in the quality of care provided in different hospitals. Methods Data from 36,116 patients with colorectal cancer who had undergone surgery were obtained from the NBOCA. These were patients from 145 and 146 hospitals from the years 2016 and 2017, respectively. A validated multiple linear regression was performed to compare the identified clinical factors with various quality outcomes. The quality outcomes defined in this study were the length of hospital stay of more than five days, two-year mortality, 30-day unplanned readmission rate, 90-day mortality, and 18-month stoma rate. Results Four clinical factors (laparoscopy rate, abdominal-perineal-resection-of-rectum, pre-operative radiotherapy, and patients with distant metastases) were shown to have a significant (p < 0.05) impact on the length of hospital stay of more than five days and the 18-month stoma rate. The 18-month stoma rate was also a significant predictor (p < 0.001) with two-year mortality. Conclusion The NBOCA should consider adjusting for these factors when reporting the quality of care provided in hospitals. Hospitals should monitor the four clinical factors for colorectal cancer patients during perioperative care. When formulating a management plan for patients with colorectal cancer, clinicians should consider these factors along with the individual patient's history. Cureus 2022-02-17 /pmc/articles/PMC8938235/ /pubmed/35371786 http://dx.doi.org/10.7759/cureus.22333 Text en Copyright © 2022, Li et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle General Surgery
Li, Chunhei
Ooi, Setthasorn Zhi Yang
Woo, Timothy
Chan, Hei Man Priscilla
Addressing the Quality of Hospital Care of Colorectal Cancer Patients Undergoing Surgery: What Can We Learn From the National Bowel Cancer Audit?
title Addressing the Quality of Hospital Care of Colorectal Cancer Patients Undergoing Surgery: What Can We Learn From the National Bowel Cancer Audit?
title_full Addressing the Quality of Hospital Care of Colorectal Cancer Patients Undergoing Surgery: What Can We Learn From the National Bowel Cancer Audit?
title_fullStr Addressing the Quality of Hospital Care of Colorectal Cancer Patients Undergoing Surgery: What Can We Learn From the National Bowel Cancer Audit?
title_full_unstemmed Addressing the Quality of Hospital Care of Colorectal Cancer Patients Undergoing Surgery: What Can We Learn From the National Bowel Cancer Audit?
title_short Addressing the Quality of Hospital Care of Colorectal Cancer Patients Undergoing Surgery: What Can We Learn From the National Bowel Cancer Audit?
title_sort addressing the quality of hospital care of colorectal cancer patients undergoing surgery: what can we learn from the national bowel cancer audit?
topic General Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8938235/
https://www.ncbi.nlm.nih.gov/pubmed/35371786
http://dx.doi.org/10.7759/cureus.22333
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