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
World Journal of Surgery – Springer Journals
Published: Dec 30, 2017
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