Postoperative cancer surgery death rates, readmissions vary in California, study finds

In-hospital mortality, 90-day readmission and 90-day mortality rates following cancer procedures varies substantially between hospitals in California, according to a study published in JAMA Open Network.

Researchers studied data obtained from linking the California Cancer Registry to hospital discharge claims databases maintained by the California Office of Statewide Health Planning and Development. They included all 351 California-based acute care hospitals at which one or more adults underwent curative intent surgery between Jan. 1, 2007, and Dec. 31, 2011. In all, 138,799 adults undergoing surgery for colorectal, breast, lung, prostate, bladder, thyroid, kidney, endometrial, pancreatic, liver or esophageal cancer within 6 months of diagnosis were included.

Of the total number of patients studied, 0.9 percent died during the initial admission. Of the 137,559 patients discharged alive, 14.3 percent were readmitted and 1.3 percent died within 90 days of the surgery.

The researchers found evidence of significant risk variation across hospitals, as characterized by variance of the random effects in the mixed model for in-hospital mortality, 90-day readmission and 90-day mortality rates.

Additionally, across 260 hospitals with a mean annual surgical volume of 10 or more, 59 had lower-than-expected rates for all three metrics; 105 had higher-than-expected rates for two of the three; and 19 had higher-than-expected rates for all three.

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