High Volume and Outcome After Liver Resection: Surgeon or Center?

Eppsteiner, Robert W.; Csikesz, Nicholas G.; Simons, Jessica P.; Tseng, Jennifer F.; Shah, Shimul A.

doi:10.1007/s11605-008-0627-3

Cited by 73 publications

(56 citation statements)

References 31 publications

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“…Due to the rise in cholecystectomy overall for a variety of procedures including biliary colic, we felt it was important for the cohort to be focused using patients that needed surgical intervention and required expertise such as AC. As we have previously described, using the surgeon identifier in the NIS enables us to study over 80,000 cases across 12 states in the 8-year period [15]. With the use of the surgeon identifier, we have shown a shift in volume over time for the highest tertile surgeons.…”

Section: Middle Tertilementioning

confidence: 74%

“…Propensity scores were used to further investigate whether differences in outcomes by selected surgeon volume groups were dependent on disparities in patient population and disease characteristics as previously described [9,15]. An advantage to the use of propensity scores is that the model is not constrained with overfitting, multiple testing, and the conventional P \ 0.05 criteria for variable inclusion.…”

Section: Case-controlled Analysismentioning

confidence: 99%

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Surgeon Volume Metrics in Laparoscopic Cholecystectomy

et al. 2009

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Section: Middle Tertilementioning

confidence: 74%

Section: Case-controlled Analysismentioning

confidence: 99%

Surgeon Volume Metrics in Laparoscopic Cholecystectomy

et al. 2009

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“…Our methods have been described previously [13,16]. The NIS is the largest national allpayer hospital inpatient care database in the United States.…”

Section: Methods and Patientsmentioning

confidence: 99%

“…In population-based studies, high hospital volume has been linked to improved patient outcomes after surgery [10][11][12][13]. This volume-outcome relationship has been shown to exist for colorectal surgery as well [14,15].…”

Section: Introductionmentioning

confidence: 99%

Hospital volume as a surrogate for laparoscopically assisted colectomy

et al. 2009

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“…[10][11][12][13][14] However, surgeon-specific processes account for a substantial component of the observed volume-outcome associations for pancreaticoduodenectomy. [15][16][17][18][19][20] It is postulated that processes related to the technical proficiency and adherence to oncologic principles during the pancreaticoduodenectomy contribute to the improved outcomes observed. Thus, operative notes may be a useful source of intraoperative process of care data for this procedure.…”

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confidence: 99%

Quality of narrative operative reports in pancreatic surgery

et al. 2013

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Background: Quality in health care can be evaluated using quality indicators (QIs). Elements contained in the surgical operative report are potential sources for QI data, but little is known about the completeness of the narrative operative report (NR). We evaluated the completeness of the NR for patients undergoing a pancreaticoduodenectomy. Methods:We reviewed NRs for patients undergoing a pancreaticoduodenectomy over a 1-year period. We extracted 79 variables related to patient and narrator characteristics, process of care measures, surgical technique and oncology-related outcomes by document analysis. Data were coded and evaluated for completeness. Results:We analyzed 74 NRs. The median number of variables reported was 43.5 (range 13-54). Variables related to surgical technique were most complete. Process of care and oncology-related variables were often omitted. Completeness of the NR was associated with longer operative duration. Conclusion:The NRs were often incomplete and of poor quality. Important elements, including process of care and oncology-related data, were frequently missing. Thus, the NR is an inadequate data source for QI. Development and use of alternative reporting methods, including standardized synoptic operative reports, should be encouraged to improve documentation of care and serve as a measure of quality of surgical care. Conclusion :Les NO sont souvent incomplètes et leur qualité laisse à désirer. Des éléments importants, dont le protocole opératoire et les données oncologiques, étaient souvent manquants. Ainsi, les NO constituent une source inadéquate de données en ce qui concerne les IQ. Il faudra encourager la mise au point et l'utilisation d'autres types de rapports, dont des synopsis opératoires standardisés, pour mieux documenter les soins chirurgicaux prodigués et pour en évaluer la qualité. Q uality improvement is an important component of health care systems. Quality in health care can be evaluated in terms of the structures, processes and outcomes of care.

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High Volume and Outcome After Liver Resection: Surgeon or Center?

Abstract: A socioeconomic bias may exist at HV centers. When these factors are accounted for and adjusted, center volume does not appear to influence in-hospital mortality unless LR is performed by HV surgeons at HV centers.

Cited by 73 publications

References 31 publications

Surgeon Volume Metrics in Laparoscopic Cholecystectomy

Surgeon Volume Metrics in Laparoscopic Cholecystectomy

Hospital volume as a surrogate for laparoscopically assisted colectomy

Quality of narrative operative reports in pancreatic surgery

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