1. Implementation and first results of a mandatory, nationwide audit on liver surgery
- Author
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van der Werf, Leonie R., Kok, Niels F. M., Buis, Carlijn I., Grünhagen, Dirk J., Hoogwater, Frederik J. H., Swijnenburg, Rutger Jan, Dulk, Marcel den, Dejong, Kees C. H. C., Klaase, Joost M., de Boer, Marieke T., Besselink, Marc G. H., van Gullik, Thomas M., Hagendoorn, Jeroen, van Hillegersberg, Richard, Liem, Mike S. L., Molenaar, I. Quintus, Patijn, Gijs A., Porte, Robert J., te Riele, Wouter W., van Santvoort, Hjalmar C., Verhoef, Kees, Burgmans, Marc C., van Delden, Otto M., van der Leij, Christiaan, Meijerink, Martijn R., Moelker, Adriaan, Prevoo, Warner, Surgery, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, CCA - Cancer Treatment and Quality of Life, Radiology and Nuclear Medicine, ACS - Amsterdam Cardiovascular Sciences, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Other Research, MUMC+: MA Heelkunde (9), RS: NUTRIM - R2 - Liver and digestive health, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, CCA - Cancer Treatment and quality of life, Radiology and nuclear medicine, Groningen Institute for Organ Transplantation (GIOT), and Value, Affordability and Sustainability (VALUE)
- Subjects
Male ,Liver surgery ,medicine.medical_specialty ,RESECTION ,ENHANCED RECOVERY ,MEDLINE ,Audit ,030230 surgery ,Liver resections ,MORBIDITY ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Hepatectomy ,Humans ,Medicine ,Registries ,Neoplasm Metastasis ,Aged ,Netherlands ,Quality Indicators, Health Care ,Retrospective Studies ,Clinical Audit ,Hepatology ,business.industry ,General surgery ,Liver Neoplasms ,Gastroenterology ,Outcome measures ,Retrospective cohort study ,CHEMOTHERAPY ,Middle Aged ,CANCER ,METASTASES ,Population Surveillance ,030220 oncology & carcinogenesis ,Female ,Colorectal Neoplasms ,business ,Complication ,Follow-Up Studies - Abstract
Background: The Dutch Hepato Biliary Audit (DHBA) was initiated in 2013 to assess the national quality of liver surgery. This study aimed to describe the initiation and implementation of this audit along with an overview of the results and future perspectives.Methods: Registry of patients undergoing liver surgery for all primary and secondary liver tumors in the DHBA is mandatory. Weekly, benchmarked information on process and outcome measures is reported to surgical teams. In this study, the first results of patients with colorectal liver metastases were presented, including results of data verification.Results: Between 2014 and 2017, 6241 procedures were registered, including 4261 (68%) resections for colorectal liver metastases. For minor- and major liver resections for colorectal liver metastases, the median [interquartile range] hospital stay was 6 [4-8] and 8 [6-12] days, respectively. A postoperative complicated course (complication leading to >14 days of hospital stay, reintervention or death) occurred in 26% and 43% and the 30-day/in-hospital mortality was 1% and 4%, respectively. The completeness of data was 97%. In 3.6% of patients, a complicated postoperative course was erroneously omitted.Conclusion: Nationwide implementation of the DHBA has been successful. This was the first step in creating a complete evaluation of the quality of liver surgery.
- Published
- 2019