• Mohammed Garout, Henry S Tilney, Paris P Tekkis, and Paul Aylin.
• Department of Epidemiology and Public Health, Imperial College London, St. Mary's Hospital, Upper Ground Floor, Praed Street, London W2 1PG, UK.
• Int J Colorectal Dis. 2008 Feb 1; 23 (2): 155-63.

BackgroundThis study compared case volume and operative mortality from surgery for colorectal cancer in England derived from Hospital Episode Statistics (HES) with the Association of Coloproctology of Great Britain and Ireland (ACPGBI) colorectal cancer database.Materials And MethodsData extracted from HES records for 2001-2002 for patients undergoing one of seven procedures for colorectal cancer were compared with those from the ACPGBI database. The primary endpoint was a 30-day post-operative mortality.Results16,346 patients from HES were compared with 7,635 from the ACPGBI database. For trusts with patients in both databases, HES reported 12% more procedures than ACPGBI (7,516 vs 6,617). Records of anterior resection revealed reasonable agreement between HES and the ACPGBI databases (difference, 2%). By trust, the overall correlation between the reported procedures was 0.660. Reported crude mortality was inconsistent between the databases, with mortality from abdominoperineal excision of rectum showing the poorest correlation (r = 0.253).ConclusionsOverall, agreement between reported caseload and mortality was reasonable at a national, but not hospital, level. Investigation of differences between the two databases at unit level may help to detect under reporting of cases. The combination of data from both sources could be used to develop an enhanced system for monitoring outcomes from colorectal surgery in England.

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