Classifying cause of death after cancer surgery.
A retrospective, single-center study was conducted to understand variation in mortality after elective cancer surgery. Fifty-two patients who died perioperatively after elective cancer resections (colon, esophageal, pancreatic, lung, gastric and liver) were identified. A methodology was developed and used during medical record review to capture the occurrence and chronology of 21 postoperative complications. Data were reviewed by 3 attending surgeons who assigned cause of death based on information from the entire clinical record. This methodology demonstrated good construct validity, with 81% agreement between cause of death assigned by expert review of data from the instrument and that assigned by expert review of the clinical records (kappa = 0.75, P < .005). Cause-specific mortality can be reliably and systematically measured after cancer surgery. Understanding variation in cause-specific mortality can inform future quality improvement efforts.
Waljee
Jennifer F
JF
Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA. filip@med.umich.edu
Windisch
Stephanie
S
Finks
Jonathan F
JF
Wong
Sandra L
SL
Birkmeyer
John D
JD
D000328:Adult; D002423:Cause of Death; D002965:Classification / Q000379:methods; D006801:Humans; D009369:Neoplasms / Q000401:mortality* / Q000601:surgery*; D011183:Postoperative Complications / Q000145:classification* / Q000401:mortality*; D015203:Reproducibility of Results; D012189:Retrospective Studies