scholarly journals The Relationship between Hospital Case Volume and Outcome from Carotid Endartectomy in England from 2000 to 2005

2007 ◽  
Vol 46 (6) ◽  
pp. 1309
Author(s):  
P.J.E. Holt ◽  
J.D. Poloniecki ◽  
I.M. Loftus ◽  
M.M. Thompson
Keyword(s):  
Case Volume ◽  
Hospital Case ◽  
The Relationship

Revisiting the Relationship Between Hospital Case Volume and Outcomes in Abdominally Based Free Flap Breast Reconstruction

2020 ◽  
Vol 85 (4) ◽  
pp. 397-401
Author(s):  
Anmol Chattha ◽  
Austin D. Chen ◽  
Justin Muste ◽  
Justin B. Cohen ◽  
Bernard T. Lee ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Free Flap ◽  
Case Volume ◽  
Hospital Case ◽  
The Relationship

scholarly journals Exploring relationships between in-hospital mortality and hospital case volume using random forest: results of a cohort study based on a nationwide sample of German hospitals, 2016–2018

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Martin Roessler ◽  
Felix Walther ◽  
Maria Eberlein-Gonska ◽  
Peter C. Scriba ◽  
Ralf Kuhlen ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Random Forest ◽  
Hospital Mortality ◽  
Patient Specific ◽  
Hospital Death ◽  
Case Volume ◽  
Hospital Case ◽  
Patient Groups ◽  
The Relationship ◽  
Strong Relationships

Abstract Background Relationships between in-hospital mortality and case volume were investigated for various patient groups in many empirical studies with mixed results. Typically, those studies relied on (semi-)parametric statistical models like logistic regression. Those models impose strong assumptions on the functional form of the relationship between outcome and case volume. The aim of this study was to determine associations between in-hospital mortality and hospital case volume using random forest as a flexible, nonparametric machine learning method. Methods We analyzed a sample of 753,895 hospital cases with stroke, myocardial infarction, ventilation > 24 h, COPD, pneumonia, and colorectal cancer undergoing colorectal resection treated in 233 German hospitals over the period 2016–2018. We derived partial dependence functions from random forest estimates capturing the relationship between the patient-specific probability of in-hospital death and hospital case volume for each of the six considered patient groups. Results Across all patient groups, the smallest hospital volumes were consistently related to the highest predicted probabilities of in-hospital death. We found strong relationships between in-hospital mortality and hospital case volume for hospitals treating a (very) small number of cases. Slightly higher case volumes were associated with substantially lower mortality. The estimated relationships between in-hospital mortality and case volume were nonlinear and nonmonotonic. Conclusion Our analysis revealed strong relationships between in-hospital mortality and hospital case volume in hospitals treating a small number of cases. The nonlinearity and nonmonotonicity of the estimated relationships indicate that studies applying conventional statistical approaches like logistic regression should consider these relationships adequately.

Is Risk of Secondary Surgery for Oronasal Fistula Following Primary Cleft Palate Repair Associated With Hospital Case Volume and Cost-to-Charge Ratio?

2021 ◽  
Vol 58 (5) ◽  
pp. 603-611
Author(s):  
Giap H. Vu ◽  
Christopher L. Kalmar ◽  
Carrie E. Zimmerman ◽  
Laura S. Humphries ◽  
Jordan W. Swanson ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Outcome Measure ◽  
Charge Ratio ◽  
Fistula Repair ◽  
Case Volume ◽  
Secondary Surgery ◽  
Hospital Case ◽  
Oronasal Fistula ◽  
Cleft Palate Repair ◽  
Palate Repair

Objective: This study assesses the association between risk of secondary surgery for oronasal fistula following primary cleft palate repair and 2 hospital characteristics—cost-to-charge ratio (RCC) and case volume of cleft palate repair. Design: Retrospective cohort study. Setting: This study utilized the Pediatric Health Information System (PHIS) database, which consists of clinical and resource-utilization data from >49 hospitals in the United States. Patients and Participants: Patients undergoing primary cleft palate repair from 2004 to 2009 were abstracted from the PHIS database and followed up for oronasal fistula repair between 2004 and 2015. Main Outcome Measure(s): The primary outcome measure was whether patients underwent oronasal fistula repair after primary cleft palate repair. Results: Among 5745 patients from 45 institutions whom met inclusion criteria, 166 (3%) underwent oronasal fistula repair within 6 to 11 years of primary cleft palate repair. Primary palatoplasty at high-RCC facilities was associated with a higher rate of subsequent oronasal fistula repair (odds ratio [OR] = 1.84 [1.32-2.56], adjusted odds ratio [AOR] = 1.81 [1.28-2.59]; P ≤ .001). Likelihood of surgery for oronasal fistula was independent of hospital case volume (OR = 0.83 [0.61-1.13], P = .233; AOR = 0.86 [0.62-1.20], P = .386). Patients with complete unilateral or bilateral cleft palate were more likely to receive oronasal fistula closure compared to those with unilateral-incomplete cleft palate (AOR = 2.09 [1.27-3.56], P = .005; AOR = 3.14 [1.80-5.58], P < .001). Conclusions: Subsequent need for oronasal fistula repair, while independent of hospital case volume for cleft palate repair, increased with increasing hospital RCC. Our study also corroborates complete cleft palate and cleft lip as risk factors for oronasal fistula.

Abstract P139: Rates of Low Output Failure After Cardiac Surgery Cannot Be Explained Solely by Preoperative Characteristics

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Donald S Likosky ◽  
Yvon R Baribeau ◽  
Jeremiah R Brown ◽  
Benjamin M Westbrook ◽  
Lawrence J Dacey ◽  
...  
Keyword(s):  
New England ◽  
Artery Bypass ◽  
Case Volume ◽  
Cabg Surgery ◽  
Operative Outcomes ◽  
Time Period ◽  
Protective Strategy ◽  
Northern New England ◽  
Future Work ◽  
The Relationship

Background: Post-operative low output failure (LOF) is an important contributor to morbidity and mortality during coronary artery bypass grafting (CABG) surgery, and may result from poor myocardial protection. We hypothesized that rates of LOF would vary across surgeons, in part attributed to their myocardial protective strategy. Methods: We identified 11,838 patients undergoing non-emergent, isolated CABG surgery utilizing cardiopulmonary bypass (CPB) at 8 centers in northern New England from 2001-2009. Our cohort included patients with preoperative ejection fractions 40+% and patients operated on by surgeons who performed 80+ CABG procedures during the time period. Patients with preoperative balloon pumps were excluded. LOF was defined as the need for an intra- or post-operative balloon pump, or return to CPB or 2+ inotropes at 48 hours. Predicted rates of LOF were estimated using logistic regression. Results: Case volume varied across surgeons (range: 80-766, median: 344). Overall rate of LOF was 5.3% (return to CPB: 3.2%, balloon pump: 1.8%, inotrope usage: 1.3%). While predicted risk of LOF did not differ across surgeons, p=0.381, observed rates varied from 1.1% to 15.6%, p=0.003 (Figure). Post-operative outcomes, including death (ptrend=0.03) or stroke (ptrend =0.02), significantly increased across surgical LOF strata (low: <2%, medium: 3-9%, high: 10+%). Conclusions There was a 14-fold variability in rates of LOF across surgeons among patients with ejection fractions 40+%. This variability could not be explained by patient case mix. Future work should focus on understanding the relationship between myocardial protective strategy and risk of LOF.

Impact of Hospital Case Volume on the Quality of Laparoscopic Colectomy in Japan

2009 ◽  
Vol 13 (9) ◽  
pp. 1619-1626 ◽  
Author(s):  
Kazuaki Kuwabara ◽  
Shinya Matsuda ◽  
Kiyohide Fushimi ◽  
Koichi B. Ishikawa ◽  
Hiromasa Horiguchi ◽  
...  
Keyword(s):  
Laparoscopic Colectomy ◽  
Case Volume ◽  
Hospital Case

scholarly journals Hospital Case Volume and Clinical Outcomes for Peptic Ulcer Treatment

2008 ◽  
Vol 23 (10) ◽  
pp. 1693-1697 ◽  
Author(s):  
Horng-Yuan Lou ◽  
Herng-Ching Lin ◽  
Kuan-Yang Chen
Keyword(s):  
Peptic Ulcer ◽  
Clinical Outcomes ◽  
Case Volume ◽  
Hospital Case ◽  
Ulcer Treatment

Mortality rates after subarachnoid hemorrhage: variations according to hospital case volume in 18 states

2003 ◽  
Vol 99 (5) ◽  
pp. 810-817 ◽  
Author(s):  
DeWitte T. Cross ◽  
David L. Tirschwell ◽  
Mary Ann Clark ◽  
Dan Tuden ◽  
Colin P. Derdeyn ◽  
...  
Keyword(s):  
Emergency Department ◽  
Subarachnoid Hemorrhage ◽  
Mortality Rate ◽  
Hospital Volume ◽  
High Volume ◽  
Mortality Rates ◽  
Case Volume ◽  
Content Type ◽  
Hospital Case ◽  
Fine Print

Object. The goal of this study was to determine whether a hospital's volume of subarachnoid hemorrhage (SAH) cases affects mortality rates in patients with SAH. For certain serious illnesses and surgical procedures, outcome has been associated with hospital case volume. Subarachnoid hemorrhage, usually resulting from a ruptured cerebral aneurysm, yields a high mortality rate. There has been no multistate study of a diverse set of hospitals to determine whether in-hospital mortality rates are influenced by hospital volume of SAH cases. Methods. The authors conducted an analysis of a retrospective, administrative database of 16,399 hospitalizations for SAH (9290 admitted through emergency departments). These hospitalizations were from acute-care hospitals in 18 states representing 58% of the US population. Both univariate and multivariate analyses were used to assess the case volume—mortality rate relationship. The authors used patient age, sex, Medicaid status, hospital region, data source year, hospital case volume quartile, and a comorbidity index in multivariate generalized estimating equations to model the relationship between hospital volume and mortality rates after SAH. Patients with SAH who were treated in hospitals in which low volumes of patients with SAH are admitted through the emergency department had 1.4 times the odds of dying in the hospital (95% confidence interval 1.2–1.6) as patients admitted to high-volume hospitals after controlling for patient age, sex, Medicaid status, hospital region, database year, and comorbid conditions. Conclusions. Patients with a diagnosis of SAH on their discharge records who initially presented through the emergency department of a hospital with a high volume of SAH cases had significantly lower mortality rates. Concentrating care for this disease in high-volume SAH treatment centers may improve overall survival.

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