Key result
Hospital postoperative mortality rankings largely reflect chance, which accounts for ~62% of the variation.
Why the study?
Are hospital rankings based on postoperative mortality rates in colorectal surgery reliable after accounting for case-mix and random variation?
Population
25,591 patients undergoing colorectal resections in 92 hospitals
Comparison
Hospital rankings based on fixed- and… vs Unadjusted analysis
Design
Cohort
Follow-up
postoperative
Authors
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Caution advised when using mortality rankings for referrals or policy; challenges their reliability and leaves open need for more stable quality metrics.
Observational (n=25,591)
Yes
Are hospital rankings based on postoperative mortality rates in colorectal surgery reliable after accounting for case-mix and random variation?
A large proportion of hospital variation in postoperative mortality for colorectal surgery is due to chance, warranting caution when interpreting hospital rankings.
Henneman et al. (2014) conducted an observational in Colorectal cancer surgery (n=25,591). Hospital ranking based on postoperative mortality was evaluated on Rankability of hospital postoperative mortality rates. Hospital rankings based on postoperative mortality rates (ranging from 0% to 8.8%) were heavily influenced by chance, with a rankability of 38% indicating 62% of variation was due to chance.