Relationship Between Volume and In-hospital Mortality in Digestive Oncological Surgery
| Autor: | Marisa Baré, Ángel Touma-Fernández, Antonio Sarría-Santamera, Paloma Pérez-López |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
In hospital mortality Colorectal cancer business.industry General Engineering Oncological surgery 030230 surgery Esophageal cancer medicine.disease Surgery Low volume 03 medical and health sciences 0302 clinical medicine Outcome variable 030220 oncology & carcinogenesis Pancreatic cancer Internal medicine medicine business Cancer surgery |
| Zdroj: | Cirugía Española (English Edition). 94:151-158 |
| ISSN: | 2173-5077 |
| DOI: | 10.1016/j.cireng.2016.02.019 |
| Popis: | 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 and 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 analysed. |
| Databáze: | OpenAIRE |
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