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Patient-reporting improves estimates of postoperative complication rates: a prospective cohort study in gynaecological oncology.

Abstract：

BACKGROUND:Most studies use hospital data to calculate postoperative complication rates (PCRs). We report on improving PCR estimates through use of patient-reporting. METHODS:A prospective cohort study of major surgery performed at 10 UK gynaecological cancer centres was undertaken. Hospitals entered the data contemporaneously into an online database. Patients were sent follow-up letters to capture postoperative complications. Grade II-V (Clavien-Dindo classification) patient-reported postoperative complications were verified from hospital records. Postoperative complication rate was defined as the proportion of surgeries with a Grade II-V postoperative complication. RESULTS:Patient replies were received for 1462 (68%) of 2152 surgeries undertaken between April 2010 and February 2012. Overall, 452 Grade II-V (402 II, 50 III-V) complications were reported in 379 of the 1462 surgeries. This included 172 surgeries with 200 hospital-reported complications and 231 with 280 patient-reported complications. All (100% concordance) 36 Grade III-V and 158 of 280 (56.4% concordance) Grade II patient-reported complications were verified on hospital case-note review. The PCR using hospital-reported data was 11.8% (172 out of 1462; 95% CI 11-14), patient-reported was 15.8% (231 out of 1462; 95% CI 14-17.8), hospital and verified patient-reported was 19.4% (283 out of 1462; 95% CI 17.4-21.4) and all data were 25.9% (379 out of 1462; 95% CI 24-28). After excluding Grade II complications, the hospital and patient verified Grade III-V PCR was 3.3% (48 out of 1462; 95% CI 2.5-4.3). CONCLUSION:This is the first prospective study of postoperative complications we are aware of in gynaecological oncology to include the patient-reported data. Patient-reporting is invaluable for obtaining complete information on postoperative complications. Primary care case-note review is likely to improve verification rates of patient-reported Grade II complications.

journal_name

Br J Cancer

journal_title

British journal of cancer

authors

Iyer R,Gentry-Maharaj A,Nordin A,Liston R,Burnell M,Das N,Desai R,Gornall R,Beardmore-Gray A,Hillaby K,Leeson S,Linder A,Lopes A,Meechan D,Mould T,Nevin J,Olaitan A,Rufford B,Ryan A,Shanbhag S,Thackeray A,Wood N

doi

10.1038/bjc.2013.366

subject

Has Abstract

pub_date

2013-08-06 00:00:00

pages

623-32

issue

eissn

0007-0920

issn

1532-1827

pii

bjc2013366

journal_volume

109

pub_type

杂志文章,多中心研究

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Patient-reporting improves estimates of postoperative complication rates: a prospective cohort study in gynaecological oncology.