Antireflux Surgery in the USA: Influence of Surgical Volume on Perioperative Outcomes and Costs—Time for Centralization?

Antireflux Surgery in the USA: Influence of Surgical Volume on Perioperative Outcomes and... Background Few studies have analyzed the relationship between surgical volume and outcomes after antireflux procedures. The aim of this study was to determine the effect of surgical volume on postoperative results and costs for patients undergoing surgery for gastroesophageal reflux disease. Methods We analyzed the National Inpatient Sample (period 2000–2013). Adult patients (C18 years old) with gastroesophageal reflux disease who underwent fundoplication were included. Hospital surgical volume was deter- mined using the 30th and 60th percentile cut points using weighted discharges and categorized as low (\10 oper- ations/year), intermediate (10–25 operations/year), or high ([25 operations/year). We performed multivariable logistic regression models to assess the effect of surgical volume on patient outcomes. Results The studied cohort comprised 75,544 patients who had antireflux surgery. When operations performed at low-volume hospitals, postoperative bleeding, cardiac failure, renal failure, respiratory failure, and inpatient mor- tality were more common. In intermediate-volume hospitals, patients were more likely to have postoperative infection, esophageal perforation, bleeding, cardiac failure, renal failure, and respiratory failure. The length of hospital stay was longer at low- and intermediate-volume hospitals (1.08 and 0.55 days longer, respectively). There was an increase in charges of 5120 dollars per patient at low-volume centers, and 4010 dollars http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png World Journal of Surgery Springer Journals

Antireflux Surgery in the USA: Influence of Surgical Volume on Perioperative Outcomes and Costs—Time for Centralization?

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Publisher
Springer International Publishing
Copyright
Copyright © 2017 by Société Internationale de Chirurgie
Subject
Medicine & Public Health; Surgery; Abdominal Surgery; Cardiac Surgery; General Surgery; Thoracic Surgery; Vascular Surgery
ISSN
0364-2313
eISSN
1432-2323
D.O.I.
10.1007/s00268-017-4429-1
Publisher site
See Article on Publisher Site

Abstract

Background Few studies have analyzed the relationship between surgical volume and outcomes after antireflux procedures. The aim of this study was to determine the effect of surgical volume on postoperative results and costs for patients undergoing surgery for gastroesophageal reflux disease. Methods We analyzed the National Inpatient Sample (period 2000–2013). Adult patients (C18 years old) with gastroesophageal reflux disease who underwent fundoplication were included. Hospital surgical volume was deter- mined using the 30th and 60th percentile cut points using weighted discharges and categorized as low (\10 oper- ations/year), intermediate (10–25 operations/year), or high ([25 operations/year). We performed multivariable logistic regression models to assess the effect of surgical volume on patient outcomes. Results The studied cohort comprised 75,544 patients who had antireflux surgery. When operations performed at low-volume hospitals, postoperative bleeding, cardiac failure, renal failure, respiratory failure, and inpatient mor- tality were more common. In intermediate-volume hospitals, patients were more likely to have postoperative infection, esophageal perforation, bleeding, cardiac failure, renal failure, and respiratory failure. The length of hospital stay was longer at low- and intermediate-volume hospitals (1.08 and 0.55 days longer, respectively). There was an increase in charges of 5120 dollars per patient at low-volume centers, and 4010 dollars

Journal

World Journal of SurgerySpringer Journals

Published: Dec 30, 2017

References

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