Trends in Hospital Volume and Operative Mortality for High-Risk Surgery

Finks, Jonathan F.; Osborne, Nicholas H.; Birkmeyer, John D.

doi:10.1056/nejmsa1010705

Cited by 1,222 publications

(818 citation statements)

References 30 publications

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“…The analyses of mortality outcomes in lung cancer patients in England in relation to surgical procedure volume adds to growing body of evidence of favourable outcomes in high-volume hospital settings (11,(13)(14)(15)(16). It is noteworthy that the 30-day mortality outcome is insufficient to capture the full mortality effect, and that 90-day mortality is more than three times the magnitude of 30-day mortality (2.8% vs. 0.9%).…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

High lung cancer surgical procedure volume is associated with shorter length of stay and lower risks of re-admission and death: National cohort analysis in England

Møller

Riaz

Holmberg

et al. 2016

European Journal of Cancer

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High lung cancer surgical procedure volume is associated with shorter length of stay and lower risks of readmission and death: national cohort analysis in England.Henrik Møller (1, 2, 3, 4), Shama Sheikh (2), Lars Holmberg (1), Erik Jakobsen (5), Jesper Lagergren (1), Richard Page (6), Michael D. Peake (3), Neil Pearce (7), Arnie Purushotham Hospitals with large lung cancer surgical resection volumes were less conservative in their selection of patients for surgical management, and provided a higher resection rate to their geographical population. The large hospitals had shorter length of stay and the odds of readmission were 15% lower in the highest hospital volume quintile compared with the lowest quintile. Mortality risks were 1% after 30 days and 3% after 90 days. Patients from hospitals in the highest volume quintile had about half the odds of death within 30 days than patients from the lowest quintile.Variations in outcomes were all in the same direction, with consistent better outcomes in the larger hospitals. This gives support to the ongoing trend towards centralisation of clinical services, but service re-organisation needs to take account of not only the size of hospitals but also referral routes and patient access.

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Section: Comparison With Other Studiesmentioning

confidence: 99%

High lung cancer surgical procedure volume is associated with shorter length of stay and lower risks of re-admission and death: National cohort analysis in England

Møller

Riaz

Holmberg

et al. 2016

European Journal of Cancer

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“…Nevertheless, mortality and morbidity rates of major cancer surgical resection range between 4% and 10% [2], and 20% and 60% [3], respectively. Postoperative complications prolong hospital stay, readmissions and costs, have significant impact on patient functioning and quality of life, and may have long-term implications on mortality [4].…”

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confidence: 99%

Promoting a culture of prehabilitation for the surgical cancer patient

2017

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Background: Traditional rehabilitative approaches to perioperative cancer care have focused on the postoperative period to facilitate the return to presurgical baseline conditions. However, there is some realization that the preoperative period can be a very effective time for intervention as the patients are more amenable to target their physiological condition to prepare to overcome the metabolic cost of the surgical stress. Methods: We undertook a narrative review of the current literature on surgical prehabilitation and discussed the current evidence of preoperative interventions before cancer surgery in order to increase physiological reserve before surgery and accelerate postoperative recovery. Results: Published data indicate the positive impact of prehabilitation on postoperative functional capacity and return to daily activities. However, the current evidence on the impact on short-and long-term clinical outcome is limited, and more research needs to be conducted. Conclusion: Preliminary findings indicate that a group of interventions such as exercise, nutrition and anxiety reduction in the preoperative period can complement the enhanced recovery program and facilitate the return to baseline activities of daily living. It is not clear at this stage whether the preoperative increase in functional capacity mitigates the burden of postoperative morbidities and subsequent cancer therapies. Therefore, more research is warranted.

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“…1,9,10 Variables Our primary outcome of interest was all-cause 30-day readmission, defined as readmission to the hospital within 30 days of discharge following an index inpatient procedure. Our main exposure was time in quarters, analyzed as a continuous variable.…”

mentioning

confidence: 99%

National Trends in Readmission Following Inpatient Surgery in the Hospital Readmissions Reduction Program Era

Mehtsun

Papanicolas

Zheng³

et al. 2018

Annals of Surgery

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Word Count: 250 Manuscript Word Count: 2,838Running Head Trends in Surgical Readmission in the HRRP Era Mini-Abstract:In this study, we sought to examine whether surgical readmission rates have declined over the past decade, and whether the Hospital Readmissions Reduction Program (HRRP) has had an influence. Surgical readmission rates have fallen over the past decade, and these declines have increased during the HRRP era.1 Objective: To investigate whether the Hospital Readmissions Reduction Program, a national program that introduced financial penalties for high readmission rates for certain medical conditions, had a "spillover" effect on surgical conditions. Summary Background Data: Over the past decade, there have been multiple national efforts to improve surgical care. Readmission rates are a key metric for assessing surgical quality.Whether surgical readmission rates have declined, and whether the Hospital Readmissions Reduction Program has had an influence is unclear. Methods:Using national Medicare data, we identified patients undergoing a range of procedures over the past decade. We examined whether certain procedures that would be targeted by the HRRP had a differential change in readmissions compared to other procedures. We used an

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Trends in Hospital Volume and Operative Mortality for High-Risk Surgery

Cited by 1,222 publications

References 30 publications

High lung cancer surgical procedure volume is associated with shorter length of stay and lower risks of re-admission and death: National cohort analysis in England

High lung cancer surgical procedure volume is associated with shorter length of stay and lower risks of re-admission and death: National cohort analysis in England

Promoting a culture of prehabilitation for the surgical cancer patient

National Trends in Readmission Following Inpatient Surgery in the Hospital Readmissions Reduction Program Era

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