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World Journal of Surgery

Published in:

01-01-2012

Application of Variable Life Adjusted Display (VLAD) to Risk-Adjusted Mortality of Esophagogastric Cancer Surgery

Authors: R. V. Guest, V. V. Chandrabalan, G. D. Murray, C. D. Auld

Published in: World Journal of Surgery | Issue 1/2012

Abstract

Purpose

In the new era of revalidation, there is an increasing need to measure surgical outcome objectively. We apply a graphical method, the Variable Life Adjusted Display (VLAD), to esophagogastric resection for malignancy. This technique charts the cumulative difference between expected and actual risk-adjusted mortality over time, allowing observation of performance trends irrespective of case-mix.

Methods

P-POSSUM was applied retrospectively to 182 consecutive patients who underwent resection for esophageal or gastric malignancy in a district general hospital. The primary outcome measured was 30-day mortality.

Results

A total of 168 patients were eligible for inclusion, with a median age of 68 years. The overall 30-day mortality rate was 4.2% compared with 7.1% as predicted by P-POSSUM. The resulting VLAD plot demonstrates an upward trend of better than predicted surgical performance.

Conclusions

VLAD has been hereby applied to esophagogastric surgery and has graphically demonstrated risk-adjusted trends in a single general surgeon’s performance. For qualitative comparative purposes, including recertification, VLAD is judged to be a simple, directly interpretable, and useful technique for monitoring surgical performance.

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Title: Application of Variable Life Adjusted Display (VLAD) to Risk-Adjusted Mortality of Esophagogastric Cancer Surgery
Authors: R. V. Guest
V. V. Chandrabalan
G. D. Murray
C. D. Auld
Publication date: 01-01-2012
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 1/2012
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-011-1303-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Application of Variable Life Adjusted Display (VLAD) to Risk-Adjusted Mortality of Esophagogastric Cancer Surgery

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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