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Post-Surgery Mortality – Lung Cancer

Key findings

The risk of death after lung cancer surgery continues to remain low, ranging from 1.5% 30 days after surgery, to 3.2% 90 days after lung cancer surgery.

Why is this important to Ontarians?

  • Better insight into mortality rates can lead to better post-operative outcomes. The rate of deaths after cancer surgery is an important measure of the quality of cancer care, especially in complex operations that carry significant risks.
  • Identifying situations where mortality rates are higher than expected helps to improve processes and, ultimately, post-surgery outcomes

See Post-surgery Mortality – Lung Methodology for technical information.

Report date: March 2019
Data sources: Canadian Institute for Health Information’s Discharge Abstract Database (CIHI-DAD), Canadian Institute for Health Information’s National Ambulatory Care Reporting System (CIHI-NACRS)
Prepared by: Analytics and Informatics, Cancer Care Ontario

Data Table 1: Thirty-day and 90-day post-surgery mortality for lung cancer patients, 2014 to 2017
Calendar Year Lung cancer patients that died within 30 days of surgery Lung cancer patients that died within 90 days of surgery
2014 1.5 3.3
2015 1.2 3.3
2016 1.3 2.8
2017 1.5 3.2

Report date: March 2019
Data sources: Canadian Institute for Health Information’s Discharge Abstract Database (CIHI-DAD), Canadian Institute for Health Information’s National Ambulatory Care Reporting System (CIHI-NACRS)
Prepared by: Analytics and Informatics, Cancer Care Ontario

Results

  • In general, 30-day and 90-day mortality after lung cancer surgery continue to remain low over the past several years.
  • The 30-day post-surgery mortality rate for lung cancer patients remained steady at 1.5% from 2014 to 2017.
  • The 90-day post-surgery mortality rate for lung cancer patients slightly decreased from 3.3% to 2.8% in 2016, but the most recent (2017) rate is 3.2%.

Comparisons

Getting comparable data and measures from multiple jurisdictions is a challenge. Be aware of the different data definitions, methodologies and years used in indicators measured outside of Ontario. Jurisdictional comparison is still useful to provide a rough indication of how well Ontario is doing relative to other provinces and countries.

  • Ontario’s post-surgical mortality rates are similar to rates in Scotland. In 2015, Scotland’s mortality rate within 30 days for those patients receiving surgery to treat lung cancer was low at 1.5%, and the 90-day post-surgery mortality rate was 3.9%.[1]
  • The Scottish target for this indicator is set at less than 5%.

Highlights

Lung surgery was regionalized in Ontario starting in 2008. Fifteen thoracic surgery designated centres exist in Ontario. This regionalization has resulted in significantly reduced post-operative mortality rates. (In fiscal years 2003/04 and2004/05, the post-operative mortality rate following pneumonectomy was 11%, versus 6% in fiscal years 2009/10 and 2010/11.)

For more information

For more information about the Surgical Oncology Program, visit the Surgical Oncology Program on Cancer Care Ontario’s website.

Visit Quality Improvement Resources for Surgical Oncology for resources to help physicians learn about, discuss and provide feedback on quality issues in cancer.

References

  1. National Services Scotland. Lung Cancer Quality Performance Indicators [Internet]. (2017) [cited 2019 April 08]. Available from https://www.isdscotland.org/Health-Topics/Quality-Indicators/Publications/2017-02-28/2017-02-28-Lung-QPI-Report.pdf