Hospital Mortality Outcomes Differ After Lung Cancer Surgery Complications

Tyler Grenda, MD House Officer VI Section of General Surgery Department of Surgery University of Michigan Interview with:
Tyler Grenda, MD
House Officer VI
Section of General Surgery
Department of Surgery
University of Michigan


Medical Research: What is the background for this study? What are the main findings?

Dr. Grenda: The main purpose for this study was to better understand the factors underlying differences in mortality rates for hospitals performing lung cancer resection.  The methodology we used included only the highest and lowest mortality hospitals (Commission on Cancer accredited cancer programs) so the sampling frame was specific. There are wide variations in mortality rates across hospitals performing lung cancer resection (overall unadjusted mortality rates were 10.8% vs. 1.6%, respectively.

Medical Research: What should clinicians and patients take away from your report?

Dr. Grenda: To better understand the factors that may underlie differences in mortality rates, we examined adherence to perioperative processes of care (e.g. adherence to venous thromboembolism prophylaxis) and outcomes following surgery between high mortality hospitals (HMHs) and low mortality hospitals (LMHs). While there were variations in adherence to some evidence-based perioperative processes of care, those variations did not translate to differences in directly related complications. In fact, there was no significant difference in complication rates between HMH and LMHs. However, we found that failure to rescue rates (or case fatality rates—deaths that occur after complications) explain much of the differences in mortality rates between HMHs and LMHs.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Grenda: Further investigation is needed to better understand the main factors related to the development of complications with a focus on their subsequent management. We need to improve our understanding of why there are differences in rates of failure to rescue.


Grenda TR, Revels SL, Yin H, Birkmeyer JD, Wong SL. Lung Cancer Resection at Hospitals With High vs Low Mortality Rates
JAMA Surg. Published online August 12, 2015. doi:10.1001/jamasurg.2015.2199. is not a forum for the exchange of personal medical information, advice or the promotion of self-destructive behavior (e.g., eating disorders, suicide). While you may freely discuss your troubles, you should not look to the Website for information or advice on such topics. Instead, we recommend that you talk in person with a trusted medical professional.

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Tyler Grenda, MD (2015). Hospital Mortality Outcomes Differ After Lung Cancer Surgery Complications

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