Validation of MTL30 as a quality indicator for colorectal surgery
Open Access
- 28 August 2020
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 15 (8), e0238473
- https://doi.org/10.1371/journal.pone.0238473
Abstract
Valid indicators are required to measure surgical quality. These ideally should be sensitive and selective while being easy to understand and adjust. We propose here the MTL30 quality indicator which takes into account 30-day mortality, transfer within 30 days, and a length of stay of 30 days as composite markers of an uneventful operative/postoperative course. Patients documented in the StuDoQ|Colon and StuDoQ|Rectal carcinoma register of the German Society for General and Visceral Surgery (DGAV) were analyzed with regard to the effects of patient and tumor-related risk factors as well as postoperative complications on the MTL30. In univariate analysis, the MTL30 correlated significantly with patient and tumor-related risk factors such as ASA score (p<0.001), age (p<0.001), or UICC stage (p<0.001). There was a high sensitivity for the postoperative occurrence of complications such as re-operations (p<0.001) or subsequent bleeding (p<0.001), as well as a significant correlation with the CDC classification (p<0.001). In multivariate analysis, patient-related risk factors and postoperative complications significantly increased the odds ratio for a positive MTL30. A negative MTL30 showed a high specify for an uneventful operative and postoperative course. The MTL30 is a valid indicator of colorectal surgical quality.Funding Information
- DFG (Open Access)
This publication has 27 references indexed in Scilit:
- After Pancreatectomy, the “90 Days from Surgery” Definition Is Superior to the “30 Days from Discharge” Definition for Capture of Clinically Relevant ReadmissionsJournal of Gastrointestinal Surgery, 2015
- Workload and surgeon´s specialty for outcome after colorectal cancer surgeryEmergencias, 2012
- Quality Assessment in SurgeryAnnals of Surgery, 2010
- Complications in colorectal surgery: risk factors and preventive strategiesPatient Safety in Surgery, 2010
- Measuring Quality of Surgical Care: Is It Attainable?Plastic and Reconstructive Surgery, 2009
- Assessing the Quality of Surgical CareSurgical Clinics of North America, 2007
- Classification of Surgical ComplicationsAnnals of Surgery, 2004
- Measuring the quality of surgical care: structure, process, or outcomes?Journal of the American College of Surgeons, 2004
- Systematic review of the definition and measurement of anastomotic leak after gastrointestinal surgeryBritish Journal of Surgery, 2001
- A policy framework for commissioning cancer servicesBMJ, 1995