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Center-Level Proced...
Center-Level Procedure Volume Does Not Predict Failure-to-Rescue After Severe Complications of Oncologic Colon and Rectal Surgery
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- Lillo-Felipe, Miriam (author)
- Department of Surgery, Örebro University Hospital, Örebro, Sweden
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- Ahl Hulme, Rebecka, 1987- (author)
- Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Stockholm, Sweden; Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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- Forssten, Maximilian Peter, 1996- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Surgery, Örebro University Hospital, Örebro, Sweden
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- Bass, Gary Alan, 1979- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Division of Traumatology, Surgical Critical Care & Emergency Surgery, University of Pennsylvania, Penn Presbyterian Medical Center, Philadelphia, USA
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- Cao, Yang, Associate Professor, 1972- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Clinical Epidemiology and Biostatistics
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- Matthiessen, Peter, 1957- (author)
- Department of Surgery, Örebro University Hospital, Örebro, Sweden
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- Mohseni, Shahin, 1978- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden
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(creator_code:org_t)
- 2021-08-27
- 2021
- English.
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In: World Journal of Surgery. - : Springer. - 0364-2313 .- 1432-2323. ; 45:12, s. 3695-3706
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Abstract
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- BACKGROUND: The relationship between hospital surgical volume and outcome after colorectal cancer surgery has thoroughly been studied. However, few studies have assessed hospital surgical volume and failure-to-rescue (FTR) after colon and rectal cancer surgery. The aim of the current study is to evaluate FTR following colorectal cancer surgery between clinics based on procedure volume.METHODS: Patients undergoing colorectal cancer surgery in Sweden from January 2015 to January 2020 were recruited through the Swedish Colorectal Cancer Registry. The primary endpoint was FTR, defined as the proportion of patients with 30-day mortality after severe postoperative complications in colorectal cancer surgery. Severe postoperative complications were defined as Clavien-Dindo ≥ 3. FTR incidence rate ratios (IRR) were calculated comparing center volume stratified in low-volume (≤ 200 cases/year) and high-volume centers (> 200 cases/year), as well as with an alternative stratification comparing low-volume (< 50 cases/year), medium-volume (50-150 cases/year) and high-volume centers (> 150 cases/year).RESULTS: A total of 23,351 patients were included in this study, of whom 2964 suffered severe postoperative complication(s). Adjusted IRR showed no significant differences between high- and low-volume centers with an IRR of 0.97 (0.75-1.26, p = 0.844) in high-volume centers in the first stratification and an IRR of 2.06 (0.80-5.31, p = 0.134) for high-volume centers and 2.15 (0.83-5.56, p = 0.116) for medium-volume centers in the second stratification.CONCLUSION: This nationwide retrospectively analyzed cohort study fails to demonstrate a significant association between hospital surgical volume and FTR after colorectal cancer surgery. Future studies should explore alternative characteristics and their correlation with FTR to identify possible interventions for the improvement of quality of care after colorectal cancer surgery.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
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- art (subject category)
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Lillo-Felipe, Mi ...
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Ahl Hulme, Rebec ...
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Forssten, Maximi ...
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Bass, Gary Alan, ...
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Cao, Yang, Assoc ...
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Matthiessen, Pet ...
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Mohseni, Shahin, ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
- Articles in the publication
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World Journal of ...
- By the university
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Örebro University
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Karolinska Institutet