Key result
Clinical management issues make ~55% of in-hospital deaths after elective colorectal cancer surgery potentially preventable.
Why the study?
The assessment of potentially avoidable mortality and associated clinical management issues following elective colorectal cancer surgery had not been reported.
What is the incidence of clinical management issues in potentially preventable deaths following elective colorectal cancer surgery?
Observational (n=243)
Yes
What is the incidence of clinical management issues in potentially preventable deaths following elective colorectal cancer surgery?
Over half of in-hospital deaths following elective colorectal cancer surgery were deemed potentially preventable, highlighting deficiencies across all stages of surgical care.
May signal opportunities to address management issues; hypothesis-generating for reducing mortality after elective colorectal cancer surgery.
BACKGROUND: Colorectal cancer (CRC) is a significant contributor to preventable deaths worldwide. The assessment of potentially avoidable mortality following elective CRC surgery has yet to be reported. The Australian and New Zealand Audit of Surgical Mortality (ANZASM) seeks to peer-review all deaths associated with surgical care. This study aims to determine the incidence of clinical management issues (CMIs) in potentially preventable deaths following elective CRC surgery. METHODS: ANZASM data from 2013 to 2023 were reviewed, and all in-hospital deaths following elective CRC surgery were selected for analysis. A predefined list of patient-care factors filled in by the treating surgeon and independent assessors was examined to identify CMIs. Deaths were categorized into two groups: potentially preventable and non-preventable. RESULTS: A total of 243 patients died after elective CRC resection over the 10-year study period. Of these, 134 (55.1%) deaths were considered potentially preventable. Compared to the non-preventable group, patients with potentially preventable deaths had higher rates of overall intraoperative (15.7% vs. 3.7%) and postoperative complications (88.8% vs. 63.3%). Potentially preventable deaths also had a greater number of CMIs per patient [median (range): 2 (1-6) vs. 1 (0-3)], with higher CMI rates during preoperative (25.0% vs. 12.8%), intraoperative (32.6% vs. 3.7%) and postoperative (58.8% vs. 28.6%) phases of surgical care. CONCLUSION: Over half of deaths following elective CRC surgery were potentially preventable. This study highlights deficiencies at all stages of surgical care and provides essential feedback to colorectal surgeons and healthcare professionals to further improve the safety and quality of care.
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Bedrikovetski et al. (2026) conducted an observational in Colorectal cancer (n=243). Potentially preventable deaths vs. Non-preventable deaths was evaluated on Proportion of potentially preventable deaths. Elective colorectal cancer surgery was associated with 243 in-hospital deaths over 10 years, of which 55.1% were considered potentially preventable due to clinical management issues.
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