-
The American surgeon · Oct 2008
Multicenter Study Comparative StudyOutcomes of esophagectomy at academic centers: an association between volume and outcome.
- Kevin M Reavis, Brian R Smith, Marcelo W Hinojosa, and Ninh T Nguyen.
- Department of Surgery, University of California, Irvine Medical Center, Orange, California 92868, USA. kreavis@uci.edu
- Am Surg. 2008 Oct 1; 74 (10): 939-43.
AbstractStudies have shown that esophagectomies performed at high-volume centers have lower in-hospital mortality. However, the volume-outcome relationship for esophagectomy performed at academic centers is unknown. Using the University HealthSystem Consortium national database, we examined the influence of the hospital's volume of esophagectomy on outcome at academic centers between January 2003 and October 2007. Outcomes including length of stay, 30-day readmission, morbidity, and observed and expected mortality were compared between high (> 12), medium (6-12), and low-volume centers' (< or = 5) annual cases. There were 30 high (n = 3984), 23 medium (n = 822), and 54 low-volume (n = 430) hospitals. Compared with low-volume counterparts, high-volume hospitals had shorter lengths of stay (14.1 vs 17.2 days, P < 0.01), fewer overall complications (51.1% vs 56.5%, P = 0.03), fewer cardiac complications (1.1% vs 2.5%, P = 0.01), fewer pulmonary complications (18.5% vs 29.8%, P < 0.01), fewer hemorrhagic complications (3.2% vs 6.7%, P < 0.01), fewer patients requiring skilled nursing facility care (9.5% vs 19.7% P < 0.01), and lower in-hospital mortality (2.5% vs 5.6%, P < 0.01). The observed-to-expected mortality ratio was 0.6 for high-volume and 1.0 for low-volume centers. Within the context of academic centers, there is a threshold of > 12 esophagectomies annually whereby there is a lower mortality and improved outcome.
Notes
Knowledge, pearl, summary or comment to share?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.
.