Abstract
Purpose
The Danish Cholecystectomy Database (DCD) was a nationwide quality database that existed from 2006 to 2011. The main goal (indicators) for the database was to increase the quality of cholecystectomy in Denmark by (1) reducing the number of primary open cholecystectomies, (2) increasing the proportion of outpatient surgery, (3) reducing the number of postoperative readmissions, and (4) reducing the number of bile duct injuries and other postoperative complications. The purpose of this study was to evaluate whether the DCD met these goals.
Methods
Data from the DCD were used to identify all patients treated with cholecystectomy in the period from 2006 to 2011. The indicators were analyzed over time as a measure of quality of cholecystectomy and analyzed using chi-square statistics.
Results
A total of 37,317 patients were included in the study. The registration rate in the DCD was around 90 %, except in 2011 where it was 70.7 %. The proportion of open cholecystectomies decreased from 2.6 % in 2006 to 0.9 % in 2011 (p < 0.0005). Likewise, in 2011, 80 % of patients undergoing cholecystectomy were discharged within 24 h, an increase compared to 2006 (p < 0.0005). The proportion of readmissions remained steady in the area of 10 % (p = 0.6). Bile duct injuries were low (0.3 %) and unchanged during the study period.
Conclusion
During the observed 6-year period, a significant increase of laparoscopic procedures was observed with more operations being performed as outpatient procedures. The proportion of readmissions and complications did not increase during this time period.
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References
Kehlet H, Bay-Nielsen M (2008) Nationwide quality improvement of groin hernia repair from the Danish Hernia Database of 87,840 patients from 1998 to 2005. Hernia 12:1–7. doi:10.1007/s10029-007-0285-5
Harboe KM, Bardram L (2011) The quality of cholecystectomy in Denmark: outcome and risk factors for 20,307 patients from the national database. Surg Endosc 25:1630–1641. doi:10.1007/s00464-010-1453-8
Ingraham AM, Cohen ME, Ko CY, Hall BL (2010) A current profile and assessment of North American cholecystectomy: results from the American College of Surgeons National Surgical Quality Improvement Program. J Am Coll Surg 211:176–186. doi:10.1016/j.jamcollsurg.2010.04.003
Enochsson L, Thulin A, Osterberg J, Sandblom G, Persson G (2013) The Swedish Registry of Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks): a nationwide registry for quality assurance of gallstone surgery. JAMA surgery 148:471–478. doi:10.1001/jamasurg.2013.1221
Harboe KM, Anthonsen K, Bardram L (2009) Validation of data and indicators in the Danish Cholecystectomy Database. Int J Qual Health Care 21:160–168. doi:10.1093/intqhc/mzp009
Sundhed.dk [Internet] Available at: http://web.archive.org/web/20140929070716/https://www.sundhed.dk/content/cms/61/1861_%C3%A5rsrapport-2009-10-doc-skrivebeskyttet1.pdf. Accessed 29/09/2014.
Harboe KM, Bardram L (2011) Nationwide quality improvement of cholecystectomy: results from a national database. Int J Qual Health Care 23:565–573. doi:10.1093/intqhc/mzr041
Sundhedsstyrelsen (2006) Referenceprogram for behandling af patienter med galdestenssygdom http://sundhedsstyrelsen.dk/publ/PUBL2006/plan/sfr/galdesten/GALDESTENSSYGDOMME.pdf.
McCambridge J, Kypri K, Elbourne D (2014) In randomization we trust? There are overlooked problems in experimenting with people in behavioral intervention trials. J Clin Epidemiol 67:247–253. doi:10.1016/j.jclinepi.2013.09.004
Neumayer L, Mastin M, Vanderhoof L, Hinson D (2000) Using the Veterans Administration National Surgical Quality Improvement Program to improve patient outcomes. J Surg Res 88:58–61. doi:10.1006/jsre.1999.5791
Best WR, Khuri SF, Phelan M, Hur K, Henderson WG, Demakis JG, Daley J (2002) Identifying patient preoperative risk factors and postoperative adverse events in administrative databases: results from the Department of Veterans Affairs National Surgical Quality Improvement Program. J Am Coll Surg 194:257–266
Ainsworth AP, Adamsen S, Rosenberg J (2005) Cholecystectomy in Denmark 1989–2003. Ugeskr Laeger 167:2648–2650
Bardram L, Rosenberg J, Kristiansen VB (2005) The Danish Cholecystectomy Database—DCD. Ugeskr Laeger 167:2618–2620
Keulemans Y, Eshuis J, de Haes H, de Wit LT, Gouma DJ (1998) Laparoscopic cholecystectomy: day-care versus clinical observation. Ann Surg 228:734–740
Kehlet H, Wilmore DW (2008) Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg 248:189–198. doi:10.1097/SLA.0b013e31817f2c1a
Authors’ contributions
Josephine Philip Rothman contributed to study conception and design, analysis and interpretation of data, and drafting of manuscript. Jakob Burcharth contributed to study conception and design, analysis and interpretation of data, drafting of manuscript, and critical revision of manuscript. Hans-Christian Pommergaard contributed to study conception and design, analysis and interpretation of data, drafting of manuscript, and critical revision of manuscript. Linda Bardram contributed to study conception and design, acquisition of data, and critical revision of manuscript. Mads Svane Liljekvist contributed to study conception and design and critical revision of manuscript. Jacob Rosenberg contributed to study conception and design, acquisition of data, analysis and interpretation of data, drafting of manuscript, and critical revision of manuscript.
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Rothman, J.P., Burcharth, J., Pommergaard, HC. et al. The quality of cholecystectomy in Denmark has improved over 6-year period. Langenbecks Arch Surg 400, 735–740 (2015). https://doi.org/10.1007/s00423-015-1322-y
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DOI: https://doi.org/10.1007/s00423-015-1322-y