Impact of procedure volumes and focused practice on short-term outcomes of elective and urgent colon cancer resection in Italy.
The relationship between hospital volumes and short-term patients' outcomes of colon cancer (CC) surgery is not well established in the literature. Moreover, evidence about short-term outcomes of urgent compared with elective CC procedures is scanty. The aims of this study are 1) to determine w...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2013-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3656123?pdf=render |
| _version_ | 1828175386500923392 |
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| author | Jacopo Lenzi Raffaele Lombardi Davide Gori Nicola Zanini Dario Tedesco Michele Masetti Elio Jovine Maria Pia Fantini |
| author_facet | Jacopo Lenzi Raffaele Lombardi Davide Gori Nicola Zanini Dario Tedesco Michele Masetti Elio Jovine Maria Pia Fantini |
| author_sort | Jacopo Lenzi |
| collection | DOAJ |
| description | The relationship between hospital volumes and short-term patients' outcomes of colon cancer (CC) surgery is not well established in the literature. Moreover, evidence about short-term outcomes of urgent compared with elective CC procedures is scanty. The aims of this study are 1) to determine whether caseloads and other hospital characteristics are associated with short-term outcomes of CC surgery; 2) to compare the outcomes of urgent and elective CC surgery.A total of 14,200 patients undergoing CC surgery between 2005 and 2010 in the General Surgery Units (GSUs) of the hospitals of Emilia-Romagna region, Northern Italy, were identified from the hospital discharge records database. The outcomes of interest were 30-day in-hospital mortality, re-intervention and 30-day re-admission. Using multilevel analysis, we analyzed the relationship of GSU volumes and focused practice, defined as the percentage of CC operations over total operations, with the three outcomes.High procedure volumes were associated with a lower risk of 30-day in-hospital mortality, after adjusting for patients' characteristics [aOR (95% CI) = 0.51 (0.33-0.81)]. Stratified analyses for elective and urgent surgery showed that high volumes were associated with a lower 30-day mortality for elective patients [aOR (95% CI) = 0.35 (0.17-0.71)], but not for urgent patients [aOR (95% CI) = 0.72 (0.42-1.24)]. Focused practice was an independent predictor of re-intervention [aOR (95% CI) = 0.67 (0.47-0.97)] and re-admission [aRR (95% CI) = 0.88 (0.78-0.98)].The present study adds evidence in support of the notion that patients with CC undergoing surgery at high-volume and focused surgical units experience better short-term outcomes. |
| first_indexed | 2024-04-12T04:27:43Z |
| format | Article |
| id | doaj.art-6012fbc94a4e43d2ae07c3549ef36424 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-12T04:27:43Z |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-6012fbc94a4e43d2ae07c3549ef364242022-12-22T03:48:01ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0185e6424510.1371/journal.pone.0064245Impact of procedure volumes and focused practice on short-term outcomes of elective and urgent colon cancer resection in Italy.Jacopo LenziRaffaele LombardiDavide GoriNicola ZaniniDario TedescoMichele MasettiElio JovineMaria Pia FantiniThe relationship between hospital volumes and short-term patients' outcomes of colon cancer (CC) surgery is not well established in the literature. Moreover, evidence about short-term outcomes of urgent compared with elective CC procedures is scanty. The aims of this study are 1) to determine whether caseloads and other hospital characteristics are associated with short-term outcomes of CC surgery; 2) to compare the outcomes of urgent and elective CC surgery.A total of 14,200 patients undergoing CC surgery between 2005 and 2010 in the General Surgery Units (GSUs) of the hospitals of Emilia-Romagna region, Northern Italy, were identified from the hospital discharge records database. The outcomes of interest were 30-day in-hospital mortality, re-intervention and 30-day re-admission. Using multilevel analysis, we analyzed the relationship of GSU volumes and focused practice, defined as the percentage of CC operations over total operations, with the three outcomes.High procedure volumes were associated with a lower risk of 30-day in-hospital mortality, after adjusting for patients' characteristics [aOR (95% CI) = 0.51 (0.33-0.81)]. Stratified analyses for elective and urgent surgery showed that high volumes were associated with a lower 30-day mortality for elective patients [aOR (95% CI) = 0.35 (0.17-0.71)], but not for urgent patients [aOR (95% CI) = 0.72 (0.42-1.24)]. Focused practice was an independent predictor of re-intervention [aOR (95% CI) = 0.67 (0.47-0.97)] and re-admission [aRR (95% CI) = 0.88 (0.78-0.98)].The present study adds evidence in support of the notion that patients with CC undergoing surgery at high-volume and focused surgical units experience better short-term outcomes.http://europepmc.org/articles/PMC3656123?pdf=render |
| spellingShingle | Jacopo Lenzi Raffaele Lombardi Davide Gori Nicola Zanini Dario Tedesco Michele Masetti Elio Jovine Maria Pia Fantini Impact of procedure volumes and focused practice on short-term outcomes of elective and urgent colon cancer resection in Italy. PLoS ONE |
| title | Impact of procedure volumes and focused practice on short-term outcomes of elective and urgent colon cancer resection in Italy. |
| title_full | Impact of procedure volumes and focused practice on short-term outcomes of elective and urgent colon cancer resection in Italy. |
| title_fullStr | Impact of procedure volumes and focused practice on short-term outcomes of elective and urgent colon cancer resection in Italy. |
| title_full_unstemmed | Impact of procedure volumes and focused practice on short-term outcomes of elective and urgent colon cancer resection in Italy. |
| title_short | Impact of procedure volumes and focused practice on short-term outcomes of elective and urgent colon cancer resection in Italy. |
| title_sort | impact of procedure volumes and focused practice on short term outcomes of elective and urgent colon cancer resection in italy |
| url | http://europepmc.org/articles/PMC3656123?pdf=render |
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