• The Journal of urology · Jun 2011

    Impact of hospital volume and laser use on postoperative complications and in-hospital mortality in cases of benign prostate hyperplasia.

    • Toru Sugihara, Hideo Yasunaga, Hiromasa Horiguchi, Hiroaki Nishimatsu, Haruki Kume, Shinya Matsuda, and Yukio Homma.
    • School of Public Health, The University of Tokyo, Tokyo, Japan. ezy04707@nifty.com
    • J. Urol. 2011 Jun 1;185(6):2248-53.

    PurposeWe analyzed the impact of hospital volume and laser use on postoperative complications and in-hospital mortality in transurethral prostatic surgery.Materials And MethodsWe evaluated data from 18,578 patients in 686 hospitals who underwent transurethral prostatic surgery between July and December, 2006 to 2008, using the Diagnosis Procedure Combination database in Japan. Cases were divided into low (14 or less per year), medium (14 to 29 per year) or high (30 or more per year) hospital volume groups. Logistic regression analyses were conducted to determine the concurrent effects of hospital volume, laser use and other factors on postoperative complications, transfusion and in-hospital mortality. Laser devices included neodymium:yttrium aluminum garnet and holmium:yttrium aluminum garnet lasers.ResultsThe overall in-hospital mortality was 0.05% (10 of 18,578 patients) and was not significantly different among groups. The transfusion rates of the low, medium and high volume groups were 8.3%, 7.0% and 5.5%, respectively (low vs high volume adjusted odds ratio 1.55, p <0.01), and postoperative complication rates were 3.7%, 3.2% and 2.6% (low vs high volume OR 1.425, p = 0.016), respectively. An absence of laser use was also a significant risk factor on both measures (OR 1.46 and 2.02, both p <0.01). Teaching hospitals were associated with a higher transfusion rate (OR 1.75), and comorbidities of chronic lung disease, chronic renal failure and malignancy were related to complication rates (OR 1.89, 2.32 and 1.50, respectively).ConclusionsThe mortality rate of transurethral prostatic surgery is extremely low and is not affected by hospital volume. However, higher surgical volumes and laser use were significantly associated with lower rates of complications and transfusions.Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…