To monitor the safety and efficacy of major resections (MR) performed for colorectal cancer among Queensland patients diagnosed between 2005-2014.
The Queensland Oncology Repository (QOR) compiles and collates administrative and clinical data from the Queensland Cancer Registry together with hospital admissions, treatment and mortality data. Based on expert clinical feedback, five new safety indicators in addition to seven existing safety indicators were created to examine and compare treatment practise in Queensland hospitals for patients diagnosed with colorectal cancer between 2005-2014.
Specialist clinicians provided direction in selecting procedure and admission codes for constructing indicators describing procedural interventions and anastomotic leaks following MR.
Over the 10-year period 2005-2014, 18,497 Queenslanders were diagnosed with colon cancer and 8,443 with rectal cancer. Almost four out of five Queensland colorectal cancer patients diagnosed between 2010-2014 underwent MR (Colon-80%; Rectal-76%).
Postoperative mortality rates were low among those patients undergoing MR. Perioperative mortality rates for colon and rectal patients were 2.7% and 1.4% respectively, with 90-day mortality rates of 4.4% and 2.6%.
Procedural interventions within the same admission were required in 5.2% of colon cancer patients and 8.4% of rectal cancer patients during 2010-2014. A smaller proportion of patients required procedural interventions in a readmission (Colon-2.4%; Rectal-4.4%).
Anastomotic leaks were rarely experienced (Colon-2.8%; Rectal-5.2%) and 90-day mortality among those with anastomotic leaks was measured (Colon-12%, Rectal-6.8%).
Colorectal cancer surgery in Queensland is being delivered in a safe and effective manner. There is value in using clinician expertise to establish new methods of measuring patient safety, going beyond routine reporting of treatment rates. Reporting these outcomes allows comparisons with other jurisdictions and enables prospective monitoring of colorectal cancer care in Queensland. Reporting and feedback to individual institutions provides opportunities to improve the standard of care for all Queensland cancer patients.