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Institutional variation in recovery after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: An opportunity for enhanced recovery pathways
Background Variations in care have been demonstrated both within and among institutions in many clinical settings. By standardizing perioperative practices, Enhanced Recovery After Surgery (ERAS) pathways reduce variation in perioperative care. We sought to characterize the variation in cytoreductiv...
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| Published in: | Journal of surgical oncology 2020-10, Vol.122 (5), p.980-985 |
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| container_title | Journal of surgical oncology |
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| creator | Eng, Oliver S. Blakely, Andrew M. Lafaro, Kelly J. Fournier, Keith F. Fackche, Nadege T. Johnston, Fabian M. Dineen, Sean Powers, Benjamin Hendrix, Ryan Lambert, Laura A. Ronnekleiv‐Kelly, Sean Walle, Kara Vande Grotz, Travis E. Leiting, Jennifer L. Patel, Sameer H. Dhar, Vikrom K. Baumgartner, Joel M. Lowy, Andrew M. Clarke, Callisia N. Mogal, Harveshp Zaidi, Mohammad Y. Staley, Charles A. Kimbrough, Charles Cloyd, Jordan M. Lee, Byrne Raoof, Mustafa |
| description | Background
Variations in care have been demonstrated both within and among institutions in many clinical settings. By standardizing perioperative practices, Enhanced Recovery After Surgery (ERAS) pathways reduce variation in perioperative care. We sought to characterize the variation in cytoreductive surgery (CRS)/heated intraperitoneal chemotherapy (HIPEC) perioperative practices among experienced US medical centers.
Methods
Data from the US HIPEC Collaborative represents a retrospective multi‐institutional cohort study of CRS and CRS/HIPEC procedures performed from 12 major academic institutions. Patient characteristics and perioperative practices were reported and compared. Institutional variation was analyzed using hierarchical mixed‐effects linear (continuous outcomes) or logistic (binary outcomes) regression models.
Results
A total of 2372 operations were included. CRS/HIPEC was performed most commonly for appendiceal histologies (64.2%). The rate of complications (overall 56.3%, range: 31.8‐70.9) and readmissions (overall 20.6%, range: 8.9‐33.3) varied by institution (P |
| doi_str_mv | 10.1002/jso.26099 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2420634684</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2420634684</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3539-f1ada81e19ab559e47f8a645319e68509cad00192605b4484676c38d92de26cf3</originalsourceid><addsrcrecordid>eNp1kc1u1DAURi1ERaeFBS-ALLGhi7T-i8dmV1W0tKrUBbCOPM4N8Sixg-1MlXfhYfF0CkhIrGzrOz5Xuh9Cbyk5p4Swi20K50wSrV-gFSVaVppo9RKtSsYqsdbkGJ2ktCWkIFK8QsecSbamWq_Qz1ufsstzdsGbAe9MdGZ_x87jCDbsIC7YdBkitksOEdrZZrcDnOb4_SnzLe6XCWLuIY7Olo85mvJ2OXgoStvDGPahmZaP-NLjME0h5tm7vOAuRAy-N95C-3feZHL_aJb0Gh11Zkjw5vk8Rd-uP329-lzdP9zcXl3eV5bXXFcdNa1RFKg2m7rWINadMlLUnGqQqibampYQqsuK6o0QSsi1tFy1mrXApO34Kfpw8E4x_Jgh5WZ0ycIwGA9hTg0TjEgupBIFff8Pug1zLKvbU4JxxZVUhTo7UDaGlCJ0zRTdaOLSUNLsK2tKZc1TZYV992ycNyO0f8jfHRXg4gA8ugGW_5uauy8PB-Uvcr-kxw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2442383868</pqid></control><display><type>article</type><title>Institutional variation in recovery after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: An opportunity for enhanced recovery pathways</title><source>Wiley</source><creator>Eng, Oliver S. ; Blakely, Andrew M. ; Lafaro, Kelly J. ; Fournier, Keith F. ; Fackche, Nadege T. ; Johnston, Fabian M. ; Dineen, Sean ; Powers, Benjamin ; Hendrix, Ryan ; Lambert, Laura A. ; Ronnekleiv‐Kelly, Sean ; Walle, Kara Vande ; Grotz, Travis E. ; Leiting, Jennifer L. ; Patel, Sameer H. ; Dhar, Vikrom K. ; Baumgartner, Joel M. ; Lowy, Andrew M. ; Clarke, Callisia N. ; Mogal, Harveshp ; Zaidi, Mohammad Y. ; Staley, Charles A. ; Kimbrough, Charles ; Cloyd, Jordan M. ; Lee, Byrne ; Raoof, Mustafa</creator><creatorcontrib>Eng, Oliver S. ; Blakely, Andrew M. ; Lafaro, Kelly J. ; Fournier, Keith F. ; Fackche, Nadege T. ; Johnston, Fabian M. ; Dineen, Sean ; Powers, Benjamin ; Hendrix, Ryan ; Lambert, Laura A. ; Ronnekleiv‐Kelly, Sean ; Walle, Kara Vande ; Grotz, Travis E. ; Leiting, Jennifer L. ; Patel, Sameer H. ; Dhar, Vikrom K. ; Baumgartner, Joel M. ; Lowy, Andrew M. ; Clarke, Callisia N. ; Mogal, Harveshp ; Zaidi, Mohammad Y. ; Staley, Charles A. ; Kimbrough, Charles ; Cloyd, Jordan M. ; Lee, Byrne ; Raoof, Mustafa</creatorcontrib><description>Background
Variations in care have been demonstrated both within and among institutions in many clinical settings. By standardizing perioperative practices, Enhanced Recovery After Surgery (ERAS) pathways reduce variation in perioperative care. We sought to characterize the variation in cytoreductive surgery (CRS)/heated intraperitoneal chemotherapy (HIPEC) perioperative practices among experienced US medical centers.
Methods
Data from the US HIPEC Collaborative represents a retrospective multi‐institutional cohort study of CRS and CRS/HIPEC procedures performed from 12 major academic institutions. Patient characteristics and perioperative practices were reported and compared. Institutional variation was analyzed using hierarchical mixed‐effects linear (continuous outcomes) or logistic (binary outcomes) regression models.
Results
A total of 2372 operations were included. CRS/HIPEC was performed most commonly for appendiceal histologies (64.2%). The rate of complications (overall 56.3%, range: 31.8‐70.9) and readmissions (overall 20.6%, range: 8.9‐33.3) varied by institution (P < .001). Institution‐level variation in perioperative practice patterns existed among measured ERAS pathway process/outcomes (P < .001). The percentages of variation with each process/outcome measure attributable solely to institutional practices ranged from 0.6% to 66.6%.
Conclusions
Significant variation exists in the perioperative care of patients undergoing CRS/HIPEC at major US academic institutions. These findings provide a strong rationale for the investigation of best practices in CRS/HIPEC patients.</description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.26099</identifier><identifier>PMID: 32627199</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Chemotherapy ; Cohort Studies ; Cytoreduction Surgical Procedures - methods ; Cytoreduction Surgical Procedures - standards ; Cytoreduction Surgical Procedures - statistics & numerical data ; cytoreductive surgery ; Enhanced Recovery After Surgery ; ERAS ; Female ; HIPEC ; Humans ; Hyperthermic Intraperitoneal Chemotherapy - methods ; Hyperthermic Intraperitoneal Chemotherapy - statistics & numerical data ; Male ; Middle Aged ; Neoplasms - drug therapy ; Neoplasms - surgery ; Neoplasms - therapy ; Perioperative care ; Recovery (Medical) ; Retrospective Studies ; Surgery ; Treatment Outcome ; variation</subject><ispartof>Journal of surgical oncology, 2020-10, Vol.122 (5), p.980-985</ispartof><rights>2020 Wiley Periodicals LLC</rights><rights>2020 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3539-f1ada81e19ab559e47f8a645319e68509cad00192605b4484676c38d92de26cf3</citedby><cites>FETCH-LOGICAL-c3539-f1ada81e19ab559e47f8a645319e68509cad00192605b4484676c38d92de26cf3</cites><orcidid>0000-0003-2679-6302 ; 0000-0002-7070-7269 ; 0000-0001-6442-1857 ; 0000-0002-7753-097X ; 0000-0003-0226-5005 ; 0000-0002-5229-961X ; 0000-0001-5743-1424 ; 0000-0003-4710-2226 ; 0000-0002-5784-7937</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32627199$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Eng, Oliver S.</creatorcontrib><creatorcontrib>Blakely, Andrew M.</creatorcontrib><creatorcontrib>Lafaro, Kelly J.</creatorcontrib><creatorcontrib>Fournier, Keith F.</creatorcontrib><creatorcontrib>Fackche, Nadege T.</creatorcontrib><creatorcontrib>Johnston, Fabian M.</creatorcontrib><creatorcontrib>Dineen, Sean</creatorcontrib><creatorcontrib>Powers, Benjamin</creatorcontrib><creatorcontrib>Hendrix, Ryan</creatorcontrib><creatorcontrib>Lambert, Laura A.</creatorcontrib><creatorcontrib>Ronnekleiv‐Kelly, Sean</creatorcontrib><creatorcontrib>Walle, Kara Vande</creatorcontrib><creatorcontrib>Grotz, Travis E.</creatorcontrib><creatorcontrib>Leiting, Jennifer L.</creatorcontrib><creatorcontrib>Patel, Sameer H.</creatorcontrib><creatorcontrib>Dhar, Vikrom K.</creatorcontrib><creatorcontrib>Baumgartner, Joel M.</creatorcontrib><creatorcontrib>Lowy, Andrew M.</creatorcontrib><creatorcontrib>Clarke, Callisia N.</creatorcontrib><creatorcontrib>Mogal, Harveshp</creatorcontrib><creatorcontrib>Zaidi, Mohammad Y.</creatorcontrib><creatorcontrib>Staley, Charles A.</creatorcontrib><creatorcontrib>Kimbrough, Charles</creatorcontrib><creatorcontrib>Cloyd, Jordan M.</creatorcontrib><creatorcontrib>Lee, Byrne</creatorcontrib><creatorcontrib>Raoof, Mustafa</creatorcontrib><title>Institutional variation in recovery after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: An opportunity for enhanced recovery pathways</title><title>Journal of surgical oncology</title><addtitle>J Surg Oncol</addtitle><description>Background
Variations in care have been demonstrated both within and among institutions in many clinical settings. By standardizing perioperative practices, Enhanced Recovery After Surgery (ERAS) pathways reduce variation in perioperative care. We sought to characterize the variation in cytoreductive surgery (CRS)/heated intraperitoneal chemotherapy (HIPEC) perioperative practices among experienced US medical centers.
Methods
Data from the US HIPEC Collaborative represents a retrospective multi‐institutional cohort study of CRS and CRS/HIPEC procedures performed from 12 major academic institutions. Patient characteristics and perioperative practices were reported and compared. Institutional variation was analyzed using hierarchical mixed‐effects linear (continuous outcomes) or logistic (binary outcomes) regression models.
Results
A total of 2372 operations were included. CRS/HIPEC was performed most commonly for appendiceal histologies (64.2%). The rate of complications (overall 56.3%, range: 31.8‐70.9) and readmissions (overall 20.6%, range: 8.9‐33.3) varied by institution (P < .001). Institution‐level variation in perioperative practice patterns existed among measured ERAS pathway process/outcomes (P < .001). The percentages of variation with each process/outcome measure attributable solely to institutional practices ranged from 0.6% to 66.6%.
Conclusions
Significant variation exists in the perioperative care of patients undergoing CRS/HIPEC at major US academic institutions. These findings provide a strong rationale for the investigation of best practices in CRS/HIPEC patients.</description><subject>Chemotherapy</subject><subject>Cohort Studies</subject><subject>Cytoreduction Surgical Procedures - methods</subject><subject>Cytoreduction Surgical Procedures - standards</subject><subject>Cytoreduction Surgical Procedures - statistics & numerical data</subject><subject>cytoreductive surgery</subject><subject>Enhanced Recovery After Surgery</subject><subject>ERAS</subject><subject>Female</subject><subject>HIPEC</subject><subject>Humans</subject><subject>Hyperthermic Intraperitoneal Chemotherapy - methods</subject><subject>Hyperthermic Intraperitoneal Chemotherapy - statistics & numerical data</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasms - drug therapy</subject><subject>Neoplasms - surgery</subject><subject>Neoplasms - therapy</subject><subject>Perioperative care</subject><subject>Recovery (Medical)</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>variation</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kc1u1DAURi1ERaeFBS-ALLGhi7T-i8dmV1W0tKrUBbCOPM4N8Sixg-1MlXfhYfF0CkhIrGzrOz5Xuh9Cbyk5p4Swi20K50wSrV-gFSVaVppo9RKtSsYqsdbkGJ2ktCWkIFK8QsecSbamWq_Qz1ufsstzdsGbAe9MdGZ_x87jCDbsIC7YdBkitksOEdrZZrcDnOb4_SnzLe6XCWLuIY7Olo85mvJ2OXgoStvDGPahmZaP-NLjME0h5tm7vOAuRAy-N95C-3feZHL_aJb0Gh11Zkjw5vk8Rd-uP329-lzdP9zcXl3eV5bXXFcdNa1RFKg2m7rWINadMlLUnGqQqibampYQqsuK6o0QSsi1tFy1mrXApO34Kfpw8E4x_Jgh5WZ0ycIwGA9hTg0TjEgupBIFff8Pug1zLKvbU4JxxZVUhTo7UDaGlCJ0zRTdaOLSUNLsK2tKZc1TZYV992ycNyO0f8jfHRXg4gA8ugGW_5uauy8PB-Uvcr-kxw</recordid><startdate>20201001</startdate><enddate>20201001</enddate><creator>Eng, Oliver S.</creator><creator>Blakely, Andrew M.</creator><creator>Lafaro, Kelly J.</creator><creator>Fournier, Keith F.</creator><creator>Fackche, Nadege T.</creator><creator>Johnston, Fabian M.</creator><creator>Dineen, Sean</creator><creator>Powers, Benjamin</creator><creator>Hendrix, Ryan</creator><creator>Lambert, Laura A.</creator><creator>Ronnekleiv‐Kelly, Sean</creator><creator>Walle, Kara Vande</creator><creator>Grotz, Travis E.</creator><creator>Leiting, Jennifer L.</creator><creator>Patel, Sameer H.</creator><creator>Dhar, Vikrom K.</creator><creator>Baumgartner, Joel M.</creator><creator>Lowy, Andrew M.</creator><creator>Clarke, Callisia N.</creator><creator>Mogal, Harveshp</creator><creator>Zaidi, Mohammad Y.</creator><creator>Staley, Charles A.</creator><creator>Kimbrough, Charles</creator><creator>Cloyd, Jordan M.</creator><creator>Lee, Byrne</creator><creator>Raoof, Mustafa</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2679-6302</orcidid><orcidid>https://orcid.org/0000-0002-7070-7269</orcidid><orcidid>https://orcid.org/0000-0001-6442-1857</orcidid><orcidid>https://orcid.org/0000-0002-7753-097X</orcidid><orcidid>https://orcid.org/0000-0003-0226-5005</orcidid><orcidid>https://orcid.org/0000-0002-5229-961X</orcidid><orcidid>https://orcid.org/0000-0001-5743-1424</orcidid><orcidid>https://orcid.org/0000-0003-4710-2226</orcidid><orcidid>https://orcid.org/0000-0002-5784-7937</orcidid></search><sort><creationdate>20201001</creationdate><title>Institutional variation in recovery after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: An opportunity for enhanced recovery pathways</title><author>Eng, Oliver S. ; Blakely, Andrew M. ; Lafaro, Kelly J. ; Fournier, Keith F. ; Fackche, Nadege T. ; Johnston, Fabian M. ; Dineen, Sean ; Powers, Benjamin ; Hendrix, Ryan ; Lambert, Laura A. ; Ronnekleiv‐Kelly, Sean ; Walle, Kara Vande ; Grotz, Travis E. ; Leiting, Jennifer L. ; Patel, Sameer H. ; Dhar, Vikrom K. ; Baumgartner, Joel M. ; Lowy, Andrew M. ; Clarke, Callisia N. ; Mogal, Harveshp ; Zaidi, Mohammad Y. ; Staley, Charles A. ; Kimbrough, Charles ; Cloyd, Jordan M. ; Lee, Byrne ; Raoof, Mustafa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3539-f1ada81e19ab559e47f8a645319e68509cad00192605b4484676c38d92de26cf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Chemotherapy</topic><topic>Cohort Studies</topic><topic>Cytoreduction Surgical Procedures - methods</topic><topic>Cytoreduction Surgical Procedures - standards</topic><topic>Cytoreduction Surgical Procedures - statistics & numerical data</topic><topic>cytoreductive surgery</topic><topic>Enhanced Recovery After Surgery</topic><topic>ERAS</topic><topic>Female</topic><topic>HIPEC</topic><topic>Humans</topic><topic>Hyperthermic Intraperitoneal Chemotherapy - methods</topic><topic>Hyperthermic Intraperitoneal Chemotherapy - statistics & numerical data</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasms - drug therapy</topic><topic>Neoplasms - surgery</topic><topic>Neoplasms - therapy</topic><topic>Perioperative care</topic><topic>Recovery (Medical)</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>variation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Eng, Oliver S.</creatorcontrib><creatorcontrib>Blakely, Andrew M.</creatorcontrib><creatorcontrib>Lafaro, Kelly J.</creatorcontrib><creatorcontrib>Fournier, Keith F.</creatorcontrib><creatorcontrib>Fackche, Nadege T.</creatorcontrib><creatorcontrib>Johnston, Fabian M.</creatorcontrib><creatorcontrib>Dineen, Sean</creatorcontrib><creatorcontrib>Powers, Benjamin</creatorcontrib><creatorcontrib>Hendrix, Ryan</creatorcontrib><creatorcontrib>Lambert, Laura A.</creatorcontrib><creatorcontrib>Ronnekleiv‐Kelly, Sean</creatorcontrib><creatorcontrib>Walle, Kara Vande</creatorcontrib><creatorcontrib>Grotz, Travis E.</creatorcontrib><creatorcontrib>Leiting, Jennifer L.</creatorcontrib><creatorcontrib>Patel, Sameer H.</creatorcontrib><creatorcontrib>Dhar, Vikrom K.</creatorcontrib><creatorcontrib>Baumgartner, Joel M.</creatorcontrib><creatorcontrib>Lowy, Andrew M.</creatorcontrib><creatorcontrib>Clarke, Callisia N.</creatorcontrib><creatorcontrib>Mogal, Harveshp</creatorcontrib><creatorcontrib>Zaidi, Mohammad Y.</creatorcontrib><creatorcontrib>Staley, Charles A.</creatorcontrib><creatorcontrib>Kimbrough, Charles</creatorcontrib><creatorcontrib>Cloyd, Jordan M.</creatorcontrib><creatorcontrib>Lee, Byrne</creatorcontrib><creatorcontrib>Raoof, Mustafa</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Eng, Oliver S.</au><au>Blakely, Andrew M.</au><au>Lafaro, Kelly J.</au><au>Fournier, Keith F.</au><au>Fackche, Nadege T.</au><au>Johnston, Fabian M.</au><au>Dineen, Sean</au><au>Powers, Benjamin</au><au>Hendrix, Ryan</au><au>Lambert, Laura A.</au><au>Ronnekleiv‐Kelly, Sean</au><au>Walle, Kara Vande</au><au>Grotz, Travis E.</au><au>Leiting, Jennifer L.</au><au>Patel, Sameer H.</au><au>Dhar, Vikrom K.</au><au>Baumgartner, Joel M.</au><au>Lowy, Andrew M.</au><au>Clarke, Callisia N.</au><au>Mogal, Harveshp</au><au>Zaidi, Mohammad Y.</au><au>Staley, Charles A.</au><au>Kimbrough, Charles</au><au>Cloyd, Jordan M.</au><au>Lee, Byrne</au><au>Raoof, Mustafa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Institutional variation in recovery after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: An opportunity for enhanced recovery pathways</atitle><jtitle>Journal of surgical oncology</jtitle><addtitle>J Surg Oncol</addtitle><date>2020-10-01</date><risdate>2020</risdate><volume>122</volume><issue>5</issue><spage>980</spage><epage>985</epage><pages>980-985</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><abstract>Background
Variations in care have been demonstrated both within and among institutions in many clinical settings. By standardizing perioperative practices, Enhanced Recovery After Surgery (ERAS) pathways reduce variation in perioperative care. We sought to characterize the variation in cytoreductive surgery (CRS)/heated intraperitoneal chemotherapy (HIPEC) perioperative practices among experienced US medical centers.
Methods
Data from the US HIPEC Collaborative represents a retrospective multi‐institutional cohort study of CRS and CRS/HIPEC procedures performed from 12 major academic institutions. Patient characteristics and perioperative practices were reported and compared. Institutional variation was analyzed using hierarchical mixed‐effects linear (continuous outcomes) or logistic (binary outcomes) regression models.
Results
A total of 2372 operations were included. CRS/HIPEC was performed most commonly for appendiceal histologies (64.2%). The rate of complications (overall 56.3%, range: 31.8‐70.9) and readmissions (overall 20.6%, range: 8.9‐33.3) varied by institution (P < .001). Institution‐level variation in perioperative practice patterns existed among measured ERAS pathway process/outcomes (P < .001). The percentages of variation with each process/outcome measure attributable solely to institutional practices ranged from 0.6% to 66.6%.
Conclusions
Significant variation exists in the perioperative care of patients undergoing CRS/HIPEC at major US academic institutions. These findings provide a strong rationale for the investigation of best practices in CRS/HIPEC patients.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32627199</pmid><doi>10.1002/jso.26099</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-2679-6302</orcidid><orcidid>https://orcid.org/0000-0002-7070-7269</orcidid><orcidid>https://orcid.org/0000-0001-6442-1857</orcidid><orcidid>https://orcid.org/0000-0002-7753-097X</orcidid><orcidid>https://orcid.org/0000-0003-0226-5005</orcidid><orcidid>https://orcid.org/0000-0002-5229-961X</orcidid><orcidid>https://orcid.org/0000-0001-5743-1424</orcidid><orcidid>https://orcid.org/0000-0003-4710-2226</orcidid><orcidid>https://orcid.org/0000-0002-5784-7937</orcidid></addata></record> |
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| ispartof | Journal of surgical oncology, 2020-10, Vol.122 (5), p.980-985 |
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| language | eng |
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| subjects | Chemotherapy Cohort Studies Cytoreduction Surgical Procedures - methods Cytoreduction Surgical Procedures - standards Cytoreduction Surgical Procedures - statistics & numerical data cytoreductive surgery Enhanced Recovery After Surgery ERAS Female HIPEC Humans Hyperthermic Intraperitoneal Chemotherapy - methods Hyperthermic Intraperitoneal Chemotherapy - statistics & numerical data Male Middle Aged Neoplasms - drug therapy Neoplasms - surgery Neoplasms - therapy Perioperative care Recovery (Medical) Retrospective Studies Surgery Treatment Outcome variation |
| title | Institutional variation in recovery after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: An opportunity for enhanced recovery pathways |
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