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An attempt to analyze the relation between hospital surgical volume and clinical outcome

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Abstract

Objectives

The aim of this study was to investigate the relation between hospital volume and clinical surgical outcome for 10 cardiac, lung, and esophageal surgical procedures.

Methods

The Committee for Scientific Affairs of the Japanese Association for Thoracic Surgery collected the pooled data on cardiac, lung, and esophageal surgical procedures between 2000 and 2004 from the annual reports. The relation between operative mortality (30-day or in-hospital mortality) and hospital volume was analyzed using a logistic regression model. The surgical procedures studied were surgery for acquired cardiac diseases [coronary artery bypass grafting (CABG), valve procedures, acute type A dissection surgery], total CABG (elective + emergency), elective CABG, emergency CABG, single-valve surgery, acute type A dissection surgery, open heart surgery for the newborn, open heart surgery for the infants, lung cancer surgery, and esophageal cancer surgery. The data used in this study were not risk-adjusted.

Results

The data on the relation between hospital volume and operative mortality generally tended to show an inverse correlation for all 10 cardiac, lung, and esophageal surgical procedures; that is, the higher was the volume the lower was the mortality. However, wide variations in operative mortality were noted among the very-low-volume hospital groups.

Conclusion

An inverse correlation was noted between hospital volume and operative mortality in the present study, although wide variations in clinical outcome were noted among the very low-volume hospitals. Further analysis is warranted using risk-adjusted data.

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Authors and Affiliations

  1. First Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan

    Teruhisa Kazui MD

  2. Department of Surgery, Division of Chest Surgery, St. Marianna University School of Medicine, Kawasaki, Japan

    Hiroaki Osada MD

  3. Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan

    Hiromasa Fujita MD

Authors
  1. Teruhisa Kazui MD
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  2. Hiroaki Osada MD
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  3. Hiromasa Fujita MD
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Committee for Scientific Affairs

Corresponding author

Correspondence to Teruhisa Kazui MD.

Additional information

This report was prepared by the Committee for Scientific Affairs, The Japanese Association for Thoracic Surgery

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Committee for Scientific Affairs., Kazui, T., Osada, H. et al. An attempt to analyze the relation between hospital surgical volume and clinical outcome. Gen Thorac Cardiovasc Surg 55, 483–492 (2007). https://doi.org/10.1007/s11748-007-0172-0

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  • DOI: https://doi.org/10.1007/s11748-007-0172-0

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