title: In-hospital mortality following lung cancer resection: nationwide administrative database.
abstract: Our aim was to determine the effect of a national strategy for quality improvement in cancer management (the "Plan Cancer") according to time period and to assess the influence of type and volume of hospital activity on in-hospital mortality (IHM) within a large national cohort of patients operated on for lung cancer.From January 2005 to December 2013, 76 235 patients were included in the French Administrative Database. Patient characteristics, hospital volume of activity and hospital type were analysed over three periods: 2005-2007, 2008-2010 and 2011-2013.Global crude IHM was 3.9%: 4.3% during 2005-2007, 4% during 2008-2010 and 3.5% during 2011-2013 (p<0.01). 296, 259 and 209 centres performed pulmonary resections in 2005-2007, 2008-2010 and 2011-2013, respectively (p<0.01). The risk of death was higher in centres performing <13 resections per year than in centres performing >43 resections per year (adjusted (a)OR 1.48, 95% CI 1.197-1.834). The risk of death was lower in the period 2011-2013 than in the period 2008-2010 (aOR 0.841, 95% CI 0.764-0.926). Adjustment variables (age, sex, Charlson score and type of resection) were significantly linked to IHM, whereas the type of hospital was not.The French national strategy for quality improvement seems to have induced a significant decrease in IHM.
authors.affiliation: Dept of Thoracic Surgery, Centre Hospitalier Universitaire Dijon, Bocage Central, Dijon, France INSERM UMR 866, Centre Hospitalier Universitaire Bocage, University of Burgundy, Dijon, France pierrebenoit.pages@chu-dijon.fr.
authors.forename: Pierre-Benoit
authors.initials: PB
authors.lastname: Pagès
authors.affiliation: Department of Biostatistics and Medical Informatics, Centre Hospitalier Universitaire Dijon, Bocage Central, Dijon, France.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cottenet
authors.affiliation: Department of Biostatistics and Medical Informatics, Centre Hospitalier Universitaire Dijon, Bocage Central, Dijon, France.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Mariet
authors.affiliation: Dept of Thoracic Surgery, Centre Hospitalier Universitaire Dijon, Bocage Central, Dijon, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Bernard
authors.affiliation: Department of Biostatistics and Medical Informatics, Centre Hospitalier Universitaire Dijon, Bocage Central, Dijon, France INSERM, CIC 1432, Clinical Investigation Centre, Clinical Epidemiology/Clinical Trials Unit, Centre Hospitalier Universitaire Bocage, University of Burgundy, Dijon, France INSERM UMR 1181, Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases, Centre Hospitalier Universitaire Bocage, University of Burgundy, Dijon, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Quantin
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003625:Data Collection; D016208:Databases, Factual; D005260:Female; D005602:France; D017052:Hospital Mortality; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D008168:Lung / Q000601:surgery; D008175:Lung Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000401:mortality*