Assessment of whether in-hospital mortality for lobectomy is a useful standard for the quality of lung cancer surgery: retrospective study

BMJ. 2003 Jul 12;327(7406):73. doi: 10.1136/bmj.327.7406.73.

Abstract

Objectives: To calculate in-hospital mortality after lobectomy for primary lung cancer in the United Kingdom; to explore the validity of using such data to assess the quality of UK thoracic surgeons; and to investigate the relation between in-hospital mortality and the number of procedures performed by surgeons.

Design: Retrospective study.

Setting: 36 departments dealing with thoracic surgery in UK hospitals.

Participants: 4028 patients who had undergone lobectomy for primary lung cancer by one of 102 surgeons.

Main outcome measures: In-hospital mortality in relation to individual surgeons, among all patients, and among each of five groups of patients defined by the number of operations performed by the surgeon.

Results: 103 patients (2.6%, 95% confidence interval 2.1% to 3.1%) died after surgery during the same hospital admission. No significant difference was found for in-hospital mortality between the five groups.

Conclusions: The number of procedures performed by a thoracic surgeon is not related to in-hospital mortality. Reporting data on in-hospital mortality after lobectomy for primary lung cancer is a poor tool for measuring a surgeon's performance.

Publication types

  • Multicenter Study

MeSH terms

  • Confidence Intervals
  • Hospital Mortality*
  • Humans
  • Lung Neoplasms / mortality
  • Lung Neoplasms / surgery*
  • Pneumonectomy / mortality*
  • Pneumonectomy / statistics & numerical data
  • Quality Indicators, Health Care*
  • Retrospective Studies
  • Survival Analysis
  • Thoracic Surgery / standards*
  • Thoracic Surgery / statistics & numerical data