Hospital volume can serve as a surrogate for surgeon volume for achieving excellent outcomes in colorectal resection. Discussion.
Annual Scientific Session of the American Surgical Association. San Diego, CA, USA, 1999/04.
Objective To examine the association of surgeon and hospital case volumes with the short-term outcomes of in-hospital death, total hospital charges, and length of stay for resection of colorectal carcinoma.
Methods The study design was a cross-sectional analysis of all adult patients who underwent resection for colorectal cancer using Maryland state discharge data from 1992 to 1996.
Cases were divided into three groups based on annual surgeon case volume-low (<=5), medium (5 to 10), and high (>10) - and hospital volume-low (<40), medium (40 to 70), and high (>=70).
Poisson and multiple linear regression analyses were used to identify differences in outcomes among volume groups while adjusting for variations in type of resections performed, cancer stage, patient comorbidities, urgency of admission, and patient demographic variables.
Results During the 5-year period, 9739 resections were performed by 812 surgeons at 50 hospitals.
The majority of surgeons (81%) and hospitals (58%) were in the low-volume group.
The low-volume surgeons operated on 3461 of the 9739 total patients (36%) at an average rate of 1.8 cases per year.
Higher surgeon volume was associated with significant improvement in all three outcomes (in-hospital death, length of stay, and cost).
Medium-volume surgeons achieved results equivalent to high-volume surgeons when they operated in high-or medium-volume hospitals. (...)
Mots-clés Pascal : Carcinome, Côlon, Rectum, Chirurgie, Etude transversale, Volume distribution, Hôpital, Association, Facteur sociodémographique, Mortalité, Résultat, Homme, Tumeur maligne, Appareil digestif pathologie, Intestin pathologie, Côlon pathologie, Rectum pathologie, Organisation santé
Mots-clés Pascal anglais : Carcinoma, Colon, Rectum, Surgery, Cross sectional study, Distribution volume, Hospital, Association, Sociodemographic factor, Mortality, Result, Human, Malignant tumor, Digestive diseases, Intestinal disease, Colonic disease, Rectal disease, Public health organization
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0516577
Code Inist : 002B25G02. Création : 18/05/2000.