title: Differences in reported esophageal cancer resection outcomes between national clinical and administrative databases.
abstract: BACKGROUND
  The Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTSD) is the largest clinical thoracic surgical database in the United States. The purpose of the present study was to determine whether the GTSD esophagectomy outcomes are representative of nationwide outcomes by comparing them with other national clinical and administrative databases.
  
  
  METHODS
  From 2002 to 2008, esophageal cancer resection outcomes from the GTSD were compared with those from the National Surgery Quality Improvement Program (NSQIP) and Nationwide Inpatient Sample (NIS). The observed differences in patient characteristics and postoperative events were also analyzed.
  
  
  RESULTS
  Annual esophageal resection volumes have increased over time. However, as of 2008, the GTSD and NSQIP only capture a small proportion of resections performed nationally (36% and 11%, respectively). The median patient age and female gender were similar in all 3 databases. Mortality was significantly lower within the GTSD (3.2%) and NSQIP (2.6%) compared with the NIS (6.1%, P < .001). The median length of stay was lower in the GTSD (10 days) than in either the NSQIP (12 days) and NIS (12 days, P < .001).
  
  
  CONCLUSIONS
  The STS GTSD reports outstanding mortality results and hospital length of stay for esophageal cancer resection. However, the surgical outcomes from the STS GTSD are not representative of the national results from programs not participating in the database. These results establish a reference for future esophagectomy comparisons and highlight the importance of increased participation and use of the STS GTSD.
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA.
authors.forename: Damien J
authors.initials: DJ
authors.lastname: Lapar
authors.forename: George J
authors.initials: GJ
authors.lastname: Stukenborg
authors.forename: Christine L
authors.initials: CL
authors.lastname: Lau
authors.forename: David R
authors.initials: DR
authors.lastname: Jones
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Kozower
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D057225:Data Mining; D016208:Databases, Factual / Q000706:statistics & numerical data*; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000209:etiology; D058996:Quality Improvement / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D012042:Registries / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome