Cancer surgery patients have more complications, but less likely to die

August 19, 2013, Henry Ford Health System

While more patients in the U.S. are suffering from complications such as blood clots and infections after major cancer surgery, fewer are dying from their operations.

The finding, part of a first-of-its-kind study by researchers at Henry Ford Hospital and others in the U.S., Canada and Germany, could lead to recommended changes in policy and a reallocation of resources.

The study was published online in British Medical Journal Open. Jesse Sammon, D.O., Henry Ford Hospital urologist, research fellow and co-author of the paper, says the seemingly contradictory finding can be explained by improved response to patient crises, but a need for better prevention of post-surgical complications.

"Our report shows that while the incidence of preventable after major , infections, and pressure ulcers – is increasing, the overall mortality of patients undergoing these procedures is decreasing in the U. S.," says Dr. Sammon.

"This paradox is explained in our report by the fact that physicians are probably getting increasingly better at identifying these adverse events early and managing them more effectively, thereby leading to lower mortality rates from adverse events and, by extension, lower overall in the entire population of patients undergoing these procedures."

That's the good news. The bad news is that more needs to be done to prevent these complications.

"Just because physicians have become increasingly effective at managing these adverse events once they occur does not obviate the fact that there's still a lot of room for improvement in reducing the actual occurrence of these adverse events in the first place," Dr. Sammon says.

The study – the largest ever to assess the quality of oncological surgical care in a nationwide sample – focused on 2.5 million surgery patients over the age of 18 who underwent a major cancer procedure between 1999 and 2009.

The operations included partial or complete removal of a cancerous colon, bladder, esophagus, stomach, uterus, lung, pancreas or prostate.

Among the findings were "marked and worrisome increases" in the frequency of infections, and respiratory failure after surgery.

But at the same time, there were also improvements in preventing anesthetic- and transfusion-related complications and hip fractures.

The researchers note the significance of this finding because Medicare curtailed the ability of hospitals to be reimbursed for "reasonably preventable events" since 2008 as an incentive to improve quality of care. The Affordable Care Act, which passed two years later, has added its own such initiatives.

"A rational approach to improving accountability for substandard care should begin with identifying the true burden of hospital-acquired adverse events," the study asserts.

In presenting their study, the researchers said it was launched at a time when medical errors in the U.S. cost an estimated $17 billion a year.

Explore further: Hospital infections in cancer patients climbed, deaths declined, study finds

More information: bmjopen.bmj.com/content/3/6/e002843.full

Related Stories

Hospital infections in cancer patients climbed, deaths declined, study finds

March 26, 2013
In a nationwide study of patients undergoing surgery for cancer, Henry Ford Hospital researchers have found that while infections during hospital stays increased during a 10-year period, the death rate from those infections ...

Medical complications in hospitalized children: The Canadian Paediatric Adverse Events Study

August 1, 2012
More children experience complications or unintended injuries, especially related to surgery, in academic hospitals compared with community hospitals, but adverse events in the former are less likely to be preventable, according ...

Hospital surgical volume should be considered when judging value of procedures

May 5, 2013
The volume of cases performed at an institution each year has a direct effect on the outcome of surgical procedures, and should always be considered when looking at the benefits of a technique, according to a team of researchers ...

"Never events" rare after bladder cancer surgery

April 5, 2013
(HealthDay)—"Never events", ten hospital-acquired conditions deemed by the Centers for Medicare and Medicaid Services as being reasonably preventable, are rare in patients with bladder cancer who have undergone radical ...

Incidence of cardiac events in lumbar spine surgery ID'd

July 23, 2013
(HealthDay)—The overall incidence of cardiac complications is 6.7 per 1,000 lumbar spine surgical procedures, and complications are more frequent with lumbar fusion versus decompression, according to a study published in ...

Robot-assisted kidney cancer surgery offers many benefits, but at a cost

May 7, 2013
Robot-assisted surgery to remove kidney cancers has seen a rapid increase in use, and has both replaced and proven safer than laparoscopic procedures for the same purpose, according to a study by the Vattikuti Urology Institute ...

Recommended for you

New approach attacks 'undruggable' cancers from the outside in

January 23, 2018
Cancer researchers have made great strides in developing targeted therapies that treat the specific genetic mutations underlying a patient's cancer. However, many of the most common cancer-causing genes are so central to ...

Study: Cells of three advanced cancers die with drug-like compounds that reverse chemo failure

January 23, 2018
Researchers at Southern Methodist University have discovered three drug-like compounds that successfully reverse chemotherapy failure in three of the most commonly aggressive cancers—ovarian, prostate and breast.

'Hijacker' drives cancer in some patients with high-risk neuroblastoma

January 23, 2018
Researchers have identified mechanisms that drive about 10 percent of high-risk neuroblastoma cases and have used a new approach to show how the cancer genome "hijacks" DNA that regulates other genes. The resulting insights ...

Enzyme inhibitor combined with chemotherapy delays glioblastoma growth

January 23, 2018
In animal experiments, a human-derived glioblastoma significantly regressed when treated with the combination of an experimental enzyme inhibitor and the standard glioblastoma chemotherapy drug, temozolomide.

Researchers identify a protein that keeps metastatic breast cancer cells dormant

January 23, 2018
A study headed by ICREA researcher Roger Gomis at the Institute for Research in Biomedicine (IRB Barcelona) has identified the genes involved in the latent asymptomatic state of breast cancer metastases. The work sheds light ...

Boosting cancer therapy with cross-dressed immune cells

January 22, 2018
Researchers at EPFL have created artificial molecules that can help the immune system to recognize and attack cancer tumors. The study is published in Nature Methods.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.