Journal of Gastrointestinal Surgery

, Volume 20, Issue 2, pp 335–342 | Cite as

Surgeon Volume Correlates with Reduced Mortality and Improved Quality in the Surgical Management of Diverticulitis

  • Rachelle N. Damle
  • Julie M. Flahive
  • Jennifer S. Davids
  • W. Brian Sweeney
  • Paul R. Sturrock
  • Justin A. Maykel
  • Karim Alavi
2015 SSAT Plenary Presentation

Abstract

Background

Volume has been shown to be an important determinant of quality and cost outcomes.

Methods

We performed a retrospective study of patients who underwent surgery for diverticulitis using the University HealthSystem Consortium database from 2008–2012. Outcomes evaluated included minimally invasive approach, stoma creation, intensive-care admission, post-operative complications, length of stay, and total direct hospital costs by surgeon volume. Surgeon volume was categorized into four categories by mean annual volumes: very-high (VHVS) (>31), high (HVS) (13–31), medium (MVS) (6–12), and low (LVS) (≤5).

Results

A total of 19,212 patients with a mean age of 59 years, 54 % female makeup, and 55 % rate of private insurance were included. Similar to the unadjusted analysis, multivariable analysis revealed decreasing odds of stoma creation, complications, ICU admission, reoperation, readmission, and inpatient mortality with increasing surgeon volume. Additionally, compared with LVS, a higher surgeon volume was associated with higher rates of the minimally invasive approach. Median length of stay and costs were also notably lower with increasing surgeon volume.

Conclusion

Quality and the use of minimally invasive technique are tightly associated with surgeon volume. Further studies are necessary to validate the direct association of volume with outcomes in surgery for diverticulitis.

Keywords

Diverticulitis Laparoscopy Volume Quality Stoma 

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Copyright information

© The Society for Surgery of the Alimentary Tract 2015

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of Massachusetts Medical SchoolWorcesterUSA
  2. 2.Center for Outcomes ResearchUniversity of Massachusetts Medical SchoolWorcesterUSA
  3. 3.Division of Colon and Rectal SurgeryUniversity of Massachusetts Medical SchoolWorcesterUSA

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