title: Measuring surgical quality: a national clinical registry versus administrative claims data.
abstract: BACKGROUND
  This study compared postoperative complications of patients who underwent pancreaticoduodenectomy (PD) recorded in the National Surgical Quality Improvement Program (NSQIP) to patients who underwent PD recorded in the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS).
  
  
  METHODS
  Data included 8,822 PD cases recorded in NSQIP and 9,827 PD cases recorded in NIS performed between 2005 and 2010. Eighteen postoperative adverse outcomes were identified in NSQIP and then matched to corresponding International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes in NIS. Using logistic regression, the relationship between database and postoperative complications was determined while accounting for patient factors.
  
  
  RESULTS
  Patients undergoing PD in the NIS were more likely to have several adverse outcomes, including urinary tract infection (odds ratio (OR) = 1.42, p < 0.001), pneumonia (OR = 1.51, p < 0.001), renal insufficiency (OR = 2.39, p < 0.001), renal failure (OR = 1.67, p = 0.005), graft/prosthetic failure (OR = 9.35, p < 0.001), and longer length of stay (1.1 days, p < 0.001). They were less likely to have cardiac arrest (OR = 0.45, p = 0.002), postoperative sepsis (OR = 0.38, p < 0.001), deep vein thrombosis (OR = 0.18, p < 0.001), and cerebrovascular accident (OR = 0.04, p = 0.003).
  
  
  CONCLUSIONS
  There is considerable discordance between NSQIP and NIS in the assessment of postoperative complications following PD, which underscores the value of recognizing the capabilities and limitations of each data source.
authors.affiliation: Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA, lenomoto@hmc.psu.edu.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Enomoto
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Hollenbeak
authors.forename: Neil H
authors.initials: NH
authors.lastname: Bhayani
authors.forename: Peter W
authors.initials: PW
authors.lastname: Dillon
authors.forename: Niraj J
authors.initials: NJ
authors.lastname: Gusani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications / Q000453:epidemiology*; D011785:Quality Assurance, Health Care / Q000379:methods* / Q000458:organization & administration; D058996:Quality Improvement; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D012042:Registries; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult