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Journal of Gastrointestinal Surgery

Published in:

01-05-2015 | Original Article

Effect of Hospital Volume on Outcomes of Laparoscopic Appendectomy for Acute Appendicitis: an Observational Study

Authors: Atsuhiko Murata, Toshihiko Mayumi, Keiji Muramatsu, Makoto Ohtani, Shinya Matsuda

Published in: Journal of Gastrointestinal Surgery | Issue 5/2015

Abstract

Background

This study investigated the effect of hospital volume on outcomes of laparoscopic appendectomy for acute appendicitis.

Methods

In total, 30,525 patients who underwent laparoscopic appendectomy for acute appendicitis were referred to 825 hospitals in Japan from 2010 to 2012. We compared appendectomy-related complications, length of stay (LOS), and medical costs in relation to hospital volume. For this study period, hospitals were categorized as low-volume hospitals (LVHs, <50 cases), medium-volume hospitals (MVHs, 50–100 cases), or high-volume hospitals (HVHs, >100 cases).

Results

Significant differences in appendectomy-related complications were observed among the LVHs, MVHs, and HVHs (6.9, 7.2, and 6.0 %, respectively; p = 0.001). Multiple logistic regression revealed that HVHs were associated with a lower relative risk of appendectomy-related complications than were LVHs and MVHs (odds ratio [OR], 0.84; 95 % confidence interval [CI], 0.74–0.95; p = 0.006). Multiple linear regression showed that HVHs were associated with shorter LOS and lower medical costs than were LVHs and MVHs. The unstandardized coefficient for LOS was −0.92 days (95 % CI, −1.07 to −0.78; p < 0.001), whereas that for medical costs was − $167.4 (95 % CI, −256.2 to −78.6; p < 0.001).

Conclusions

Hospital volume was significantly associated with laparoscopic appendectomy outcomes.

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Title: Effect of Hospital Volume on Outcomes of Laparoscopic Appendectomy for Acute Appendicitis: an Observational Study
Authors: Atsuhiko Murata
Toshihiko Mayumi
Keiji Muramatsu
Makoto Ohtani
Shinya Matsuda
Publication date: 01-05-2015
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 5/2015
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-015-2746-y

At a glance: The STEP trials

Springer Medicine

Effect of Hospital Volume on Outcomes of Laparoscopic Appendectomy for Acute Appendicitis: an Observational Study

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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