首页|Impact of surgical volume on nationwide hospital mortality after pancreaticoduodenectomy

Impact of surgical volume on nationwide hospital mortality after pancreaticoduodenectomy

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  • NETL
  • NSTL
  • 万方数据
  • 维普
AIM:To evaluate the impact of surgical volume on nationwide hospital mortality after pancreaticoduodenectomy (PD) for periampullary tumors in South Korea.METHODS:Periampullary cancer patients who underwent PD between 2005 and 2008 were analyzed from the database of the Health Insurance Review and Assessment Service of South Korea.A total of 126 hospitals were divided into 5 categories,each similar in terms of surgical volume for each category.We used hospital mortality as a quality indicator,which was defined as death during the hospital stay for PD,and calculated adjusted mortality through multivariate logistic models using several confounder variables.RESULTS:A total of eligible 4975 patients were enrolled in this study.Average annual surgical volume of hospitals was markedly varied,ranging from 215 PDs in the very-high-volume hospital to ＜ 10 PDs in the verylow-volume hospitals.Admission route,type of medical security,and type of operation were significantly different by surgical volume.The overall hospital mortality was 2.1％ and the observed hospital mortality by surgical volume showed statistical difference.Surgical volume,age,and type of operation were independent risk factors for hospital death,and adjusted hospital mortality showed a similar difference between hospitals with observed mortality.The result of the HosmerLemeshow test was 5.76 (P =0.674),indicating an acceptable appropriateness of our regression model.CONCLUSION:The higher-volume hospitals showed lower hospital mortality than the lower-volume hospitals after PD in South Korea,which were clarified through the nationwide database.

Hospital mortalityPancreaticoduodenectomySouth KoreaDatabasesFactualLogistic modelsRisk factors

Chul-Gyu Kim、Sungho Jo、Jae Sun Kim

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Department of Nursing, Cheongju University,Cheongju, Chungbuk 360-764, South Korea

Department of Surgery, Dankook University College of Medicine, Cheoan, Chungnam 330-714, South Korea

Health Insurance Review and Assessment Service,Seoul 137-706, South Korea

2012

10.3748/wjg.v18.i31.4175

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子：1.001
ISSN：1007-9327
年,卷(期)：2012.18(31)
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