A National Database Analysis Comparing the Nationwide Inpatient Sample and American College of Surgeons National Surgical Quality Improvement Program in Laparoscopic vs Open Colectomies: Inherent Variance May Impact Outcomes

摘要: BACKGROUND Clinical and administrative databases each have fundamental distinctions inherent limitations that may impact results. OBJECTIVE This study aimed to compare the American College of Surgeons National Surgical Quality Improvement Program Nationwide Inpatient Sample, focusing on similarities, differences, both data sets. DESIGN All elective open laparoscopic segmental colectomies from (2006-2013) Sample (2006-2012) were reviewed. International Classification Diseases, Ninth Revision, Modification coding identified cases, Current Procedural Terminology for Program. Common demographics comorbidities identified, in-hospital outcomes evaluated. SETTINGS A national sample was extracted population databases. PATIENTS Data derived database: 188,326 cases (laparoscopic = 67,245; 121,081); Program: 110,666 54,191; 56,475). MAIN OUTCOME MEASURES Colectomy used as an avenue differences in patient characteristics between these 2 RESULTS Laparoscopic colectomy demonstrated superior compared with open; therefore, results focused comparing a minimally invasive approach among Because size, many variables statistically different without clinical relevance. Coding discrepancies rate conversion (3%) (15%) The prevalence nonmorbid obesity anemia more than twice Sample. Sepsis greater Program, urinary tract infections acute kidney injury having frequency cohort. site higher (30-day) vs (8.4% 2.6%; p < 0.01), albeit less when restricted occurred before discharge (3.3% 0.01). LIMITATIONS is retrospective using population-based data. CONCLUSION analysis large regarding highlights incidence previously unrecognized variability. These can subsequent conclusions/recommendations. findings underscore importance carefully choosing understanding sets designing interpreting research.