90-day postoperative mortality after elective colorectal cancer surgery

What this data shows:

The outcome measure assessed for this publication is the 90-day mortality rate following planned removal of a bowel cancer – that is the proportion of patients undergoing surgery who die from whatever cause within 90 days of their operation.

How the data is gathered:

All NHS Trusts are required to send data on all patients they treat for bowel cancer to a central database. The results reported here have been adjusted for case-mix to reflect that some surgeons take on more difficult cases or high risk patients.

When the data is shown:

It is normal for different clinicians and units to have different results and there is an expected range results can fall in. Sometimes results may fall outside the expected range, which could be an indication that the care provided is either significantly poorer or significantly better than expected. But sometimes these results just happen by chance. Detecting whether a result falls outside the expected range by change or because of a significant reason can be challenging. We want to reduce the times when we identify a unit or individuals results as being outside of the expected range just because of chance.

We can do this by using a wide definition of the expected range. The narrower the definition of the expected range the greater the chance of a result being labelled as outside of it just because of chance.

Audits participating in publication on NHS.uk and My NHS are asked to use statistical analysis to do this.

Where we are able to identify a unit or individuals results as being significantly outside of the expected range using a wide definition, we will show this on the site. We don’t show units or individuals as being outside of the expect range using a narrower definition.

We have used “funnel plots” to investigate whether there are systematic differences between the risk-adjusted 90-day mortality rates of individual surgeons. The funnel limit is set that if a surgeon’s mortality rate is the same as the national average, there is a 1 in 1000 chance that this surgeon will have a mortality result above the funnel limit.

More information about the data source:

Data Source:

National Bowel Cancer Audit

Data Period:

April 2012 to March 2017

Data Supplier:

Association of Coloproctology of Great Britain & Ireland

Further Information:

Please see ACPGBI website http://www.acpgbi.org.uk/surgeon-outcomes.