Relationship between volume and in-hospital mortality in digestive oncological surgery

被引:12
作者
Perez-Lopez, Paloma [1 ,2 ]
Bare, Marisa [3 ,4 ]
Touma-Fernandez, Angel [5 ]
Sarria-Santamera, Antonio [4 ,6 ,7 ]
机构
[1] Univ Alcala de Henares, Fac Med, Unidad Docente Cirugia, E-28871 Alcala De Henares, Spain
[2] Ctr Invest Biomed Red Bioingn Biomat & Nanomed CI, Madrid, Spain
[3] Univ Autonoma Barcelona, Parc Tauli Sabadell, Epidemiol Clin & Cribado Canc, E-08193 Barcelona, Spain
[4] Red Invest Serv Salud & Enfermedades Cron REDISSE, Paris, France
[5] Hosp Morales Meseguer, Serv Anestesiol, Murcia, Spain
[6] Univ Alcala de Henares, Fac Med, Unidad Docente Salud Publ Med Legal & Hist Cienci, E-28871 Alcala De Henares, Spain
[7] Agencia Evaluac Tecnol Sanitarias, Inst Salud Carlos III, Madrid, Spain
来源
CIRUGIA ESPANOLA | 2016年 / 94卷 / 03期
关键词
Gastrointestinal surgery; High-volume hospitals; Low-volume hospitals; In-hospital mortality; Esophageal cancer; Gastric cancer; Colorectal cancer; Pancreatic cancer; COLORECTAL-CANCER; SURGICAL VOLUME; ESOPHAGECTOMY; OUTCOMES; FAILURE; RESCUE;
D O I
10.1016/j.ciresp.2015.09.005
中图分类号
R61 [外科手术学];
学科分类号
摘要
Introduction: The results previously obtained in Spain in the study of the relationship between surgical caseload and in-hospital mortality are inconclusive. The aim of this study is to evaluate the volume-outcome association in Spain in the setting of digestive oncological surgery. Methods: An analytical, cross-sectional study was conducted with data from patients who underwent surgical procedures with curative intent of esophageal, gastric, colorectal and pancreatic neoplasms between 2006-2009 with data from the Spanish MBDS. In-hospital mortality was used as outcome variable. Control variables were patient, health care and hospital characteristics. Exposure variable was the number of interventions for each disease, dividing the hospitals in 3 categories: high volume (HV), mid volume (MV) and low volume (LV) according to the number of procedures. Results: An inverse, statistically significant relationship between procedure volume and in-hospital mortality was observed for both volume categories in both gastric (LV: OR = 1,50 [IC 95%: 1,28-1,76]; MV: OR = 1,49 (IC 95%: 1,28-1,74)) and colorectal (LV: OR = 1,44 [IC 95%: 1,33-1,55]; MV: OR = 1,24 [IC 95%: 1,15-1,33]) cancer surgery. In pancreatic procedures, this difference was only statistically significant between LV and HV categories (LV: OR = 1,89 [IC 95%: 1,29-2,75]; MV: OR = 1,21 [IC 95%: 0,82-1,79]). Esophageal surgery also showed an inverse relationship, which was not statistically significant (LV: OR = 1,89 [IC 95%: 0,98-3,64]; MV: OR = 1,05 [IC 95%: 0,50-2,21]). Conclusions: The results of this study suggest the existence in Spain of an inverse relationship between caseload and in-hospital mortality in digestive oncological surgery for the procedures analyzed. (C) 2015 AEC. Published by Elsevier Espana, S.L.U. All rights reserved.
引用
收藏
页码:151 / 158
页数:8
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