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Quality indicators and outcomes in colorectal cancer
  • +9
  • Jose M. Quintana,
  • Ane Anton,
  • Santiago Lazaro,
  • Nerea Gonzalez,
  • Marisa Baré,
  • Nerea Fernández de Larrea-Baz,
  • Maximino Redondo,
  • Antonio Escobar,
  • Cristina Sarasqueta,
  • SUSANA GARCIA-GUTIERREZ,
  • Urko Aguirre-Larracoechea,
  • Eduardo Briones
Jose M. Quintana
Hosp Galdakao Usansolo

Corresponding Author:josemaria.quintanalopez@osakidetza.eus

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Ane Anton
Hosp Galdakao Usansolo
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Santiago Lazaro
Hospital Universitario Basurto
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Nerea Gonzalez
Hosp Galdakao Usansolo
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Marisa Baré
Hospital de Sabadell
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Nerea Fernández de Larrea-Baz
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Maximino Redondo
Hospital Costa del Sol
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Antonio Escobar
Hospital de Basurto, Bilbao, Bizkaia, Spain
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Cristina Sarasqueta
Hospital Universitaria Donostia
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SUSANA GARCIA-GUTIERREZ
Hosp Galdakao Usansolo
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Urko Aguirre-Larracoechea
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Eduardo Briones
UDG Salud Publica, Distrito AP Sevilla
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Abstract

Aims. Some quality indicators of proper health care in patients with colorectal cancer have been established. Our goal was to evaluate the outcomes of performing certain procedures or treatments, included as quality indicators, in the follow-up of colorectal cancer patients. Methods. This was a prospective cohort study of patients diagnosed with colorectal cancer who underwent surgery and were followed at 1, 2, 3 and 5 years. CT scanning, colonoscopy, chemotherapy and radiotherapy were evaluated in relation to various clinical outcomes and PROM changes over five years. Multivariable generalized linear mixed models were used to evaluate their effect on mortality, complications, recurrence, and PROM changes (HAD, EQ-5D, EORTC-Q30) at the next follow-up. Results. CT scanning or colonoscopy was related to a decrease in the risk of dying, while chemotherapy at a specified moment was related to an increased risk. In the case of recurrence, CT scanning and chemotherapy showed statistically increased the risk, while all the procedures and treatments influenced complications. Regarding PROM scales, CT scanning, colonoscopy and radiotherapy showed statistically significant results with respect to an increase in anxiety and decrease in quality of life measured by the EORTC. However, undergoing radiotherapy at a specified moment increased depression levels, and overall, receiving radiotherapy decreased the quality of life of the patients, as measured by the EuroQol-5d. Conclusions. After adjustment for sociodemographic factors, comorbidities and severity of the disease, performing certain quality indicators of proper health care in patients with colorectal cancer was related to less mortality but higher adverse outcomes.