Nationwide effect of high procedure volume in lung cancer surgery on in-house mortality in Germany
Background - The literature reports that hospital caseload volume is associated with survival for lung cancer resection. The aim of this study is to explore this association in a nationwide setting according to individual hospital caseload volume of every inpatient case in Germany. - Methods - This...
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| Main Authors: | , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
31 August 2020
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| In: |
Lung cancer
Year: 2020, Volume: 149, Pages: 78-83 |
| ISSN: | 1872-8332 |
| DOI: | 10.1016/j.lungcan.2020.08.018 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.lungcan.2020.08.018 Verlag, lizenzpflichtig, Volltext: http://www.sciencedirect.com/science/article/pii/S0169500220305924 
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| Author Notes: | Philip Baum, Johannes Diers, Johannes Haag, Laura Klotz, Florian Eichhorn, Martin Eichhorn, Armin Wiegering, Hauke Winter |
| Summary: | Background - The literature reports that hospital caseload volume is associated with survival for lung cancer resection. The aim of this study is to explore this association in a nationwide setting according to individual hospital caseload volume of every inpatient case in Germany. - Methods - This retrospective analysis of nationwide hospital discharge data in Germany between 2014 and 2017 comprises 121,837 patients of whom 36,051 (29.6 %) underwent surgical anatomic resection. Hospital volumes were defined according to the number of patient resections for lung cancer in each hospital, and patients were categorized into 5 quintiles based on hospital caseload volume. A logistic regression model accounting for death according to sex, age, comorbidity, and resection volume was calculated, and effect modification was evaluated using the Mantel-Haenszel method. - Results - In-house mortality ranged from 2.1 % in very high-volume centers to 4.0 % in very low-volume hospitals (p<0.01). In multivariable logistic regression analysis, lower in-house mortality in very high-volume centers performing > 140 anatomic lung resections per year was observed compared with very low-volume centers performing < 27 resections (OR, 0.58; CI, 0.46 to 0.72; p<0.01). This relationship also held for failure to rescue rates (12.9 vs 16.7 %, p=0.01), although a greater number of extended resections were performed (23.1 vs. 14.8 %, p<0.01). - Conclusions - Hospitals with high volumes of lung cancer resections performed surgery with a higher ratio of complex procedures and achieved reduced in-house mortality, fewer complications, and lower failure to rescue rates. |
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| Item Description: | Gesehen am 23.11.2020 |
| Physical Description: | Online Resource |
| ISSN: | 1872-8332 |
| DOI: | 10.1016/j.lungcan.2020.08.018 |