Hospital case volume linked with better GI cancer surgery outcomes
Hospitals in the highest tier of case volume may offer better outcomes for patients undergoing surgery for gastrointestinal cancers, according to study results.
Ninh T. Nguyen, MD, from the department of surgery at the University of California, Irvine Medical Center, and colleagues analyzed perioperative outcomes based on U.S. News & World Report rankings of hospitals for GI and GI surgery.
“Our study demonstrates the U.S. News & World Report ranking is a very appropriate resource,” Nguyen said in a press release. “Now that we've actually done this analysis, we see the ranking does make sense when you look at surgical case volume and other related issues. Patients who seek surgical care at the top-ranked hospitals actually fare better, particularly if they are treated for the complex surgical conditions examined in this study.”
Researchers reviewed data from patients who underwent esophagectomy, gastrectomy and pancreatectomy between January and December 2018 using the Vizient database. The primary outcome of the study was in-hospital mortality. They also assessed other outcomes, including length of stay, mortality index, rate of serious complication and cost.
In the 42 top-ranked hospitals, researchers identified 3,054 complex GI cancer resections mean annual cases (n = 73) compared with 3,608 in 198 non-ranked hospitals (mean annual cases 18).
Compared with non-ranked hospitals, top-ranked hospitals had lower in-hospital mortality (2.26% vs. 0.96%’ P < .001) and lower mortality index (1.53 vs. 0.71). There was no significant difference in the other secondary outcomes of cost, length of stay and serious complication rate.
Top-ranked hospitals also had lower mortality among patients who developed serious complications (8.2% vs. 16.8%; P < .01).
“Deciding where to go for treatment is a collaborative decision that should be made between the patient and their physician,” Nguyen said in the release. “But one of the resources you can use is the annual U.S. News & World Report list. These are complex GI operations with a much higher risk of mortality. Therefore, you really want to go to a hospital where the surgical team performs a lot of these operations.”
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