According to a recent report in the online JAMA Surgery, differences in mortality rates after lung cancer resection at hospitals across the country boil down to one key factor: a difference in failure-to-rescue rates when complications arise.
“A better understanding of the cause of failure to rescue may be crucial for improving mortality rates following lung cancer resection,” the study authors wrote.
A team of researchers at the Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, looked at patient data at 18 hospitals ranked low-mortality hospitals by the Commission on Cancer and compared it with data from another 25 facilities ranked high-mortality hospitals. Among 645 patients, 441 received lung cancer resections at low-mortality hospitals and 204 at high-mortality hospitals.
After adjusting for patient and cancer risk factors, the team found that lung cancer resection at the high-morality hospitals had an 8.1% mortality rate compared with a 1.8% rate for the same procedure at low-mortality hospitals—a difference they categorized as significant. Complication rates were not significantly different, though, at 23.3% for high-mortality hospitals and 15.6% at low-morality hospitals.
However, at 25.9%, failure-to-rescue rates were significantly higher at high-mortality hospitals, reported the researchers, led by Sandra L. Wong, MD. Low-mortality hospitals had a failure-to-rescue rate averaging just 8.7%.
“This finding emphasizes the need for a better understanding of the factors related to complications following lung cancer operations and their subsequent management to identify areas that may have the most powerful effect on quality improvement,” the researchers wrote.—Jolynn Tumolo
