Causes of mortality after colon surgery across hospitals

Editor's Note

Significant variation exists in mortality across hospitals for colon cancer surgery, this study finds.

The analysis included 3,025 patients who had colon surgery at 19 low-mortality (1,006) and 30 high-mortality (2,019) hospitals.

Researchers found a wide difference in mortality between high-mortality and low-mortality hospitals (9.3% vs 2.4%). Compared with low-mortality hospitals, high-mortality hospitals had more patients who:

• were black (11.2% vs 6.5%)
• had 2 or more comorbidities (22.7% vs 18.9%)
• were ASA class 4-5 (11.9% vs 5.3%)
• were functionally dependent (13.9% vs 8.8%).

Rates of complications were similar in high- and low-mortality hospitals, but for patients with complications, fatality rates were significantly higher in high-mortality hospitals.