Dataset Information

Days at Home after Surgery: An Integrated and Efficient Outcome Measure for Clinical Trials and Quality Assurance.

ABSTRACT:

Background

Surgical audit, sometimes including public reporting, is an important foundation of high quality health care. We aimed to assess the validity of a novel outcome metric, days at home up to 30?days after surgery, as a surgical outcome measure in clinical trials and quality assurance.

Methods

This was a multicentre, registry-based cohort study. We used prospectively collected hospital and national healthcare registry data obtained from patients aged 18?years or older undergoing a broad range of surgeries in Sweden over a 10-year period. The association between days at home up to 30?days after surgery and patient (older age, poorer physical status, comorbidity) and surgical (elective or non-elective, complexity, duration) risk factors, process of care outcomes (re-admissions, discharge destination), clinical outcomes (major complications, 30-day mortality) and death up to 1?year after surgery were measured.

Findings

From January, 2005, to December, 2014, we obtained demographic and perioperative data on 636,885 patients from 21 Swedish hospitals. Mortality at 30?days and one year was 1.8% and 7.3%, respectively. The median (IQR) days at home up to 30?days after surgery was 27 (23-29), being significantly lower among high-risk patients, those recovering from more complex surgical procedures, and suffering serious postoperative complications (all p?InterpretationDays at home up to 30?days after surgery is a valid, easy to measure patient-centred outcome metric. It is highly sensitive to changes in surgical risk and impact of complications, and has prognostic importance; it is therefore a valuable endpoint for perioperative clinical trials and quality assurance.

Funding

Swedish National Research Council Medicine and Stockholm County Council ALF-project grant (LE), and the Australian National Health and Medical Research Council (PM).

SUBMITTER: Bell M

PROVIDER: S-EPMC6610780 | biostudies-literature | 2019 May-Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Days at Home after Surgery: An Integrated and Efficient Outcome Measure for Clinical Trials and Quality Assurance.

Bell Max M Eriksson Lars I LI Svensson Tobias T Hallqvist Linn L Granath Fredrik F Reilly Jennifer J Myles Paul S PS

EClinicalMedicine 20190427

<h4>Background</h4>Surgical audit, sometimes including public reporting, is an important foundation of high quality health care. We aimed to assess the validity of a novel outcome metric, <i>days at home up to 30 days after surgery</i>, as a surgical outcome measure in clinical trials and quality assurance.<h4>Methods</h4>This was a multicentre, registry-based cohort study. We used prospectively collected hospital and national healthcare registry data obtained from patients aged 18 years or olde ...[more]

PMID: 31317130

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Dataset Information

Days at Home after Surgery: An Integrated and Efficient Outcome Measure for Clinical Trials and Quality Assurance.

Background

Methods

Findings

Funding

Publications

Days at Home after Surgery: An Integrated and Efficient Outcome Measure for Clinical Trials and Quality Assurance.

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