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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 9/2015

01-09-2015 | 2015 SSAT Quick Shot Presentation

Trends in Hospital Volume and Failure to Rescue for Pancreatic Surgery

Authors: Neda Amini, Gaya Spolverato, Yuhree Kim, Timothy M. Pawlik

Published in: Journal of Gastrointestinal Surgery | Issue 9/2015

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Abstract

Background

We sought to evaluate trends in selection of high volume (HV) hospitals for pancreatic surgery, as well as examine trends in preoperative complications, mortality, and failure to rescue (FTR).

Method

Patients who underwent pancreatic resection between 2000 and 2011 were identified from the Nationwide Inpatient Sample (NIS). Preoperative morbidity, mortality, and FTR were examined over time. Hospital volume was stratified into tertiles based on the number of pancreatic resections per year for each time period. Logistic regression models were used to assess the effect of hospital volume on risk of complication, postoperative mortality, and FTR over time.

Result

A total of 35,986 patients were identified. Median hospital volume increased from 13 in 2000–2003 to 55 procedures/year in 2008–2011 (P < 0.001). Morbidity remained relatively the same over time at low volume (LV), intermediate volume (IV), and HV hospitals (all P > 0.05). Overall postoperative mortality was 5 %, and it decreased over time across all hospital volumes (P < 0.05). FTR was more common at LV (12.0 %) and IV (8.5 %) volume hospitals compared with HV hospitals (6.4 %). The improvement in FTR over time was most pronounced at LV and IV hospitals versus HV hospitals (P = 0.001).

Conclusion

Median hospital volume for pancreatic surgery has increased over the past decade. While the morbidity remained relatively stable over time, mortality improved especially in LV and IV hospitals. This improvement in mortality seems to be related to a decreased FTR.
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Metadata
Title
Trends in Hospital Volume and Failure to Rescue for Pancreatic Surgery
Authors
Neda Amini
Gaya Spolverato
Yuhree Kim
Timothy M. Pawlik
Publication date
01-09-2015
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 9/2015
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-015-2800-9

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