541 UTILIZING THE INTERNATIONAL WEB-BASED ESODATA DATABASE TO AUDIT AND DOCUMENT EVOLUTION IN ECCG COMPLICATIONS INCIDENCE, DEFINITIONS AND QUALITY MEASURES

Abstract

Abstract The Esophageal Complications Consensus Group (ECCG) standardized the reporting of complications associated with esophagectomy in 2015. Since then, international data on patients’ perioperative outcomes have been prospectively recorded in the web-based Esodata.org dataset. This international collaboration provides a unique opportunity to utilize a standardized reporting platform to report current esophagectomy outcomes as well as the evolution of outcomes and quality measures associated with esophagectomy over time. Methods Esophagectomy data on complications and quality measures have prospectively been collected on the Esodata dataset since 2015. Between January 2017 and January 2019, 41 high volume centers recorded outcomes on 3,318 esophageal resections at their institutions. Current complication incidence, as well as trends in patient demographics, operative approaches and quality outcome measures were compared between the 2,407 esophagectomies done between 2015 and 2016 and the 3,318 patients recorded between 2017–2018. Overall results of 6,022 resections in the entire Esodata database as of January 2019 are also reported. Results Demographic outcomes of 6,022 patients included males 78.3%, mean-age 63.3, resections for cancer 96.6%. Operative demographics included minimally invasive procedures 52.8%, chest anastomosis 63.7%, neoadjuvant chemoradiotherapy 48.7% and R0 resections 93.5%. Quality measure outcomes included readmissions 9.7%, 30- and 90-day mortality 2.0% and 4.5%, transfusions 12%, escalation in care 22.1%, and discharge home 89.4%. For trends in complications, see Table 1. Trends in quality measures demonstrated improvements in readmissions 11.1–8.5%, blood transfusions 14.3–10.2%, escalation in care 24.5–20% but a decrease in patients being discharged home 91.4–87.8%. Anastomotic leak increased from 11.7% to 13.1% (NS) but leaks requiring surgery decreased 3.3–3.0%. Conclusion The ECCG complications, definitions and quality measures platform provided a standardized approach to not only benchmark outcomes including complications but also to assess trends in service delivery and outcomes over time. The International Esodata Study Group and the Esodata database provided a robust vehicle for assessing contemporary international demographics and outcomes, monitoring practice trends and carrying out future prospective studies.