Assurance de qualité pour le cancer rectal – phase 2 ...

KCE Reports 81 PROCARE – phase 2 47Figure 13 provides an overview of the per-centre-analysis using the administrativedatabase. Twelve centres (of which 11 centres treated 6 or less eligible patients) have ascore of 0%, while in 8 centres all patients still have a stoma 1 year after SSO withtemporary stoma. All these 8 centres treated 2 or less eligible patients. Forty-nine and54 centres have a score above the weighted (27%; 95%CI 24 – 30%) and unweightedmean (33%; 95%CI 28 – 38%) respectively. Risk-adjustment (e.g. tumour localisation,stage, comorbidities) is necessary for the correct interpretation of these results.Table 35. Number of patients with stoma 1 year after sphincter-sparingsurgery, measured with administrative data.NPatients with rectal cancer that underwent sphincter-sparing surgery 3692Patients with stoma surgery and/or use of stoma material within 1 year 1504Patients with stoma and available information on stoma after 1 year (denominator) 1093Patients with stoma after 1 year (numerator) 292 (27%)Figure 13. Per-centre-analysis (n = 107) of stoma 1 year after sphinctersparingsurgery (administrative cohort) $ .Proportion (%)100908070605040302010050454035302520151050Number of patients (N)$ The weighted mean is presented with a red bar, the unweighted mean is presented with a bluehorizontal line. The grey bars represent the QI value per centre, while the blue dots representthe number of patients per centre. These results are preliminary, and cannot be used to judge thequality of care.Rate of patients with major leakage of the anastomosisDEFINITIONNumerator: all patients with RC undergoing sphincter-sparing radical resection andhaving major leakage of the anastomosis requiring re-intervention(s) during or afterhospitalisation for radical resection.Denominator: all patients with RC undergoing sphincter-sparing radical resection.Exclusion:• patients not undergoing sphincter-sparing surgery• patients undergoing LE/TEMSRESULTSOf the patients that underwent sphincter-sparing surgery, 5% had a major leakage of theanastomosis requiring re-intervention (Table 36). Importantly, the code used tocalculate this QI does not take into account late leakages of the anastomosis.