Skip to main content
Article
Colectomy performance improvement within NSQIP 2005-2008
Surgery Publications and Presentations
  • Deepak K. Ozhathil, University of Massachusetts Medical School
  • YouFu Li, University of Massachusetts Medical School
  • Jillian K. Smith, University of Massachusetts Medical School
  • Elan R. Witkowski, University of Massachusetts Medical School
  • Elizaveta Ragulin Coyne, University of Massachusetts Medical School
  • Karim Alavi, University of Massachusetts Medical School
  • Jennifer F. Tseng, University of Massachusetts Medical School
  • Shimul A. Shah, University of Massachusetts Medical School
UMMS Affiliation
Department of Surgery, Surgical Outcomes Analysis and Research
Date
11-1-2011
Document Type
Article
Medical Subject Headings
Adult; Aged; Aged, 80 and over; Colectomy; Databases, Factual; Emergency Treatment; Female; Humans; Laparoscopy; Male; Middle Aged; Morbidity; Outcome and Process Assessment (Health Care); Postoperative Complications; *Quality Assurance, Health Care; Retrospective Studies; Risk Factors; Surgical Procedures, Elective; Young Adult
Disciplines
Abstract
BACKGROUND: All open and laparoscopic colectomies submitted to the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) were evaluated for trends and improvements in operative outcomes. METHODS: 48,247 adults (>/=18 y old) underwent colectomy in ACS NSQIP, as grouped by surgical approach (laparoscopic versus open), urgency (emergent versus elective), and operative year (2005 to 2008). Primary outcomes measured morbidity, mortality, perioperative, and postoperative complications. RESULTS: The proportion of laparoscopic colectomies performed increased annually (26.3% to 34.0%), while open colectomies decreased (73.7% to 66.0%; P < 0.0001). Most emergent colectomies were open procedures (93.5%) representing 24.3% of all open cases. The overall risk-adjusted morbidity and mortality for all colectomy procedures did not show a statistically significant change over time, however, morbidity and mortality increased among open colectomies (r = 0.03) and decreased among laparoscopic colectomies (r = -0.04; P < 0.0001). Postoperative complications reduced significantly including superficial surgical site infections (9.17% to 8.20%, P < 0.004), pneumonia (4.60% to 3.97%, P < 0.0001), and sepsis (4.72%, 2005; 6.81%, 2006; 5.62%, 2007; 5.09%, 2008; P < 0.0002). Perioperative improvements included operative time (169.2 to 160.0 min), PRBC transfusions (0.27 to 0.25 units) and length of stay (10.5 to 6.61 d; P < 0.0001). CONCLUSION: It appears that laparoscopic colectomies are growing in popularity over open colectomies, but the need for emergent open procedures remains unchanged. Across all colectomies, however, key postoperative and perioperative complications have improved over time. Participation in ACS NSQIP demonstrates quality improvement and may encourage greater enrollment.
Comments

Citation: J Surg Res. 2011 Nov;171(1):e9-13. Epub 2011 Jul 23. Link to article on publisher's site

Medical student Deepak Ozhathill participated in this study as part of the Senior Scholars research program at the University of Massachusetts Medical School.

Related Resources
Link to Article in PubMed
PubMed ID
21872886
Citation Information
Deepak K. Ozhathil, YouFu Li, Jillian K. Smith, Elan R. Witkowski, et al.. "Colectomy performance improvement within NSQIP 2005-2008" Vol. 171 Iss. 1 (2011) ISSN: 0022-4804 (Linking)
Available at: http://works.bepress.com/jennifer_tseng/78/