Cited 33 times since 2017 (4.5 per year) source: EuropePMC Annals of surgery, Volume 266, Issue 5, 1 1 2017, Pages 898-904 Textbook Outcome: A Composite Measure for Quality of Elective Aneurysm Surgery. Karthaus EG, Lijftogt N, Busweiler LAD, Elsman BHP, Wouters MWJM, Vahl AC, Hamming JF, Dutch Society of Vascular Surgery, the Steering Committee of the Dutch Surgical Aneurysm Audit, the Dutch Institute for Clinical Auditing
Objective
To investigate a new composite quality measurement, which comprises a desirable outcome for elective aneurysm surgery, called "Textbook Outcome" (TO).
Background
Single-quality indicators in vascular surgery are often not distinctive and insufficiently reflect the quality of care.
Methods
All patients undergoing elective abdominal aortic aneurysm repair, registered in the Dutch Surgical Aneurysm Audit between 2014 and 2015 were included. TO was defined as the percentage of patients who had abdominal aortic aneurysm-repair without intraoperative complications, postoperative surgical complications, reinterventions, prolonged hospital stay [endovascular aneurysm repair (EVAR) ≤4 d, open surgical repair (OSR) ≤10 d], readmissions, and postoperative mortality (≤30 d after surgery/at discharge). Case-mix adjusted TO rates were used to compare hospitals and to compare individual hospital results for different procedures.
Results
Five thousand one hundred seventy patients were included, of whom 4039 were treated with EVAR and 1131 with OSR. TO was achieved in 71% of EVAR and 53% of OSR. Important obstacles for achieving TO were a prolonged hospital stay, postoperative complications, and readmissions. Adjusted TO rates varied from 38% to 89% (EVAR) and from 0% to 97% (OSR) between individual hospitals. Hospitals with a high TO for OSR also had a high TO for EVAR; however, a high TO for EVAR did not implicate a high TO for OSR.
Conclusions
TO generates additional information to evaluate the overall quality of the care of elective aneurysm surgery, which subsequently can be used by hospitals to improve the quality of their care.
