Thema: Presse: Resection experience leads to improved outcomes
Presse: Resection experience leads to improved outcomes
Katja[a]
09.04.2004 15:02:47
Cancer 2004;100:999-1007.
Greater brain tumor resection experience leads to improved outcomes
Numerous reports have shown that the outcomes for a particular surgery improve as the hospital volume and surgeon caseload for that procedure increases. This also appears to be true of resection of metastatic brain tumors.
The findings, which are reported in the March 1st issue of Cancer, are based on a study of nearly 14,000 operations that were performed in the US between 1988 and 2000.
Overall, 3.1% of patients died during their hospital stay and 16.7% were not sent directly home, study author Dr. Fred G. Barker, from Harvard Medical School in Boston, notes.
Hospital volume and surgeon caseload were both inversely associated with the mortality risk, but only the link with surgeon caseload remained statistically significant on multivariate analysis (p=0.004). The risk of not being discharged to home decreased significantly as both hospital volume and surgeon caseload rose.
During the 13-year period, a 79% increase in the annual number of resections was observed. During this time, in-hospital mortality fell from 4.6% to 2.3%.
Shorter lengths of stay were seen with higher-volume providers and hospital charges were lower if the operations were performed by higher-caseload surgeons.
Further studies are needed to confirm the findings "before their use in formulating population-wide health policies," Dr. Barker notes. However, he also points out that they may be of use to patients seeking "high-quality surgical care, and for those physicians responsible for advising them."
Reuters Health
Posting Date: March 26, 2004
Greater brain tumor resection experience leads to improved outcomes
Numerous reports have shown that the outcomes for a particular surgery improve as the hospital volume and surgeon caseload for that procedure increases. This also appears to be true of resection of metastatic brain tumors.
The findings, which are reported in the March 1st issue of Cancer, are based on a study of nearly 14,000 operations that were performed in the US between 1988 and 2000.
Overall, 3.1% of patients died during their hospital stay and 16.7% were not sent directly home, study author Dr. Fred G. Barker, from Harvard Medical School in Boston, notes.
Hospital volume and surgeon caseload were both inversely associated with the mortality risk, but only the link with surgeon caseload remained statistically significant on multivariate analysis (p=0.004). The risk of not being discharged to home decreased significantly as both hospital volume and surgeon caseload rose.
During the 13-year period, a 79% increase in the annual number of resections was observed. During this time, in-hospital mortality fell from 4.6% to 2.3%.
Shorter lengths of stay were seen with higher-volume providers and hospital charges were lower if the operations were performed by higher-caseload surgeons.
Further studies are needed to confirm the findings "before their use in formulating population-wide health policies," Dr. Barker notes. However, he also points out that they may be of use to patients seeking "high-quality surgical care, and for those physicians responsible for advising them."
Reuters Health
Posting Date: March 26, 2004
Katja[a]
