Changes in surgical volume and outcomes over time for women undergoing hysterectomy for endometrial cancer
Obstetrics and Gynecology, ISSN: 1873-233X, Vol: 132, Issue: 1, Page: 59-69
2018
- 25Citations
- 13Captures
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
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Metrics Details
- Citations25
- Citation Indexes25
- 25
- CrossRef23
- Captures13
- Readers13
- 13
Article Description
OBJECTIVE: To examine changes over time in surgeon and hospital procedural volume for hysterectomy for endometrial cancer and explore the association between changes in volume and perioperative outcomes. METHODS: We used the Statewide Planning and Research Cooperative System database to analyze women who underwent abdominal or minimally invasive hysterectomy from 2000 to 2014. Annualized surgeon and hospital volume was estimated. The association between surgeon and hospital volume and perioperative morbidity, mortality, and resource utilization (transfusion, length of stay, hospital charges) was estimated by modeling procedural volume as a continuous and categorical variable. RESULTS: A total of 44,558 women treated at 218 hospitals were identified. The number of surgeons performing cases each year decreased from 845 surgeons with 2,595 patients (mean cases53) in 2000 to 317 surgeons who operated on 3,119 patients (mean cases510) (P<.001) in 2014, whereas the mean hospital volume rose from 14 to 32 cases over the same time period (P5.29). When stratified by surgeon volume quartiles, the morbidity rate was 14.6% among the lowest volume surgeons, 20.8% for medium-low, 15.7% for medium-high, and 14.1% for high-volume surgeons (P<.001). In multivariable models in which volume was modeled as a continuous variable, there was no association between surgeon volume and the rate of complications, whereas excessive total charges were lowest and perioperative mortality highest for the high-volume surgeons (P<.001 for both). CONCLUSION: Care of women with endometrial cancer has been concentrated to a smaller number of surgeons and hospitals. The association between surgeon and hospital volume for endometrial cancer is complex with an increased risk of adverse outcomes among mediumvolume hospitals and surgeons but the lowest complication rates for the highest volume surgeons and centers.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85064344228&origin=inward; http://dx.doi.org/10.1097/aog.0000000000002691; http://www.ncbi.nlm.nih.gov/pubmed/29889759; https://journals.lww.com/00006250-201807000-00011; https://dx.doi.org/10.1097/aog.0000000000002691; https://journals.lww.com/greenjournal/Fulltext/2018/07000/Changes_in_Surgical_Volume_and_Outcomes_Over_Time.11.aspx
Ovid Technologies (Wolters Kluwer Health)
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