The relative effect of hospital and surgeon volume on failure to rescue among patients undergoing liver resection for cancer

Stefan Buettner, Faiz Gani, Neda Amini, Gaya Spolverato, Yuhree Kim, Arman Kilic, Doris Wagner, Timothy M. Pawlik

Research output: Contribution to journalArticlepeer-review

Abstract

Background Although previous reports have focused on factors at the hospital level to explain variations in postoperative outcomes, less is known regarding the effect of provider-specific factors on postoperative outcomes such as failure-to-rescue (FTR) and postoperative mortality. The current study aimed to quantify the relative contributions of surgeon and hospital volume on the volume-outcomes relationship among a cohort of patients undergoing liver resection. Methods Patients undergoing liver surgery for cancer were identified using the Nationwide Inpatient Sample from 2001 and 2009. Multivariable logistic regression analysis was performed to identify factors associated with mortality and FTR. Point estimates were used to calculate the relative effects of hospital and surgeon volume on mortality and FTR. Results A total of 5,075 patients underwent liver surgery and met inclusion criteria. Median patient age was 62 years (interquartile range, 52-70) and 55.2% of patients were male. Mortality was lowest among patients treated at high-volume hospitals and among patients treated by high-volume surgeons (both P

Original languageEnglish (US)
Pages (from-to)1004-1012
Number of pages9
JournalSurgery
Volume159
Issue number4
DOIs
StatePublished - Apr 1 2016

ASJC Scopus subject areas

  • Surgery

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