Transcript So what is our true stoma rate?

So what is our true stoma
rate?
Background
• NBOCAP September 2012
– 1/8/2008 – 31/7/2012
– 71% permanent stoma rate
– National mean 57.1%
• Source
– HES data
NBOCAP validation
• Final_cancer_site is derived from
ICD10_major_site code in conjunction with
primary_procedure_name,
teletherapy_type_given and
pat_proc_result_t_mri_scan_1
NBOCAP validation
• Note that the permanent stoma rate is estimated
as follows:
• A patient is assumed to have had a stoma if:
– coded as having a stoma (temporary or permanent) in
the Audit
– OR coded as having a stoma in HES
– OR procedure (from Audit where recorded,
otherwise from HES) is APER or Hartmann's
• A stoma is assumed to have been
reversed only if:
–
procedure (from Audit where recorded,
otherwise from HES) was NOT an APER
– AND stoma reversal is coded in HES
between day of surgery and 12 months from
surgery
Source
• Northumbria Healthcare
• All cancer operations April 2010 to September
2011
• Source
–
–
–
–
SIRIS
Pathology
(notes)
Amalgamated into separate database
Rectal cancer resections
• 81 resections
– 8 (9/9%) no stoma
– 71 (87.7%) primary stoma
– 2 (2.5%) secondary stoma
Primary stoma
• N = 71
– 42 (59%) temporary intent
– 27 (38%) permanent intent
– 2 (3%) uncertain intent
Secondary stoma
• N=2
– Uncertain intent
Stoma closure
• Reversed N = 33
– 33/42 (79%) temporary intent
– 0/4 uncertain intent
• Not reversed N=40
– 9/42 (21%) temporary intent
– 4/4 uncertain intent
Overall
• No stoma 41/81 (51%)
• Stoma 40/81 (49%)
• Temporary intent not closed
– 3 leaks
– 3 metastases
– 2 strictures
– 1 death
Conclusions
• Difficult to analyse data without independent
database
• HES data may be misleading
• Need clinician ownership of HES data
• Who enters data into Somerset?
• We need to understand how the data will be
analysed to enter it correctly