Hiroyuki Konno1,2, Kinji Kamiya3, Hirotoshi Kikuchi3, Hiroaki Miyata4,5, Norimichi Hirahara5, Mitsukazu Gotoh4,5, Go Wakabayashi4, Tetsuo Ohta6, Norihiro Kokudo7, Masaki Mori6, Yasuyuki Seto6. 1. The Japanese Society of Gastroenterological Surgery, Database Committee, Tokyo, Japan. kon_6416@hama-med.ac.jp. 2. Second Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Higashi-ku, Hamamatsu, 431-3192, Japan. kon_6416@hama-med.ac.jp. 3. Second Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Higashi-ku, Hamamatsu, 431-3192, Japan. 4. The Japanese Society of Gastroenterological Surgery, Database Committee, Tokyo, Japan. 5. National Clinical Database, Tokyo, Japan. 6. The Japanese Society of Gastroenterological Surgery, Tokyo, Japan. 7. Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Abstract
PURPOSE: The aim of this study is to evaluate the association between the participation of board-certified surgeons in gastroenterological surgery (BCS-Gs) and the surgical outcomes of gastroenterological surgery. METHODS: Data from the National Clinical Database on patients who underwent eight major gastroenterological procedures were analyzed retrospectively. First, the ratio of cases in which BCS-G were involved to the total cases was calculated for each procedure, and the impact of BCS-G involvement on surgical outcome was assessed by comparing mortality rates in the group with BCS-G involvement vs. the group without BCS-G involvement. Second, the differences in the observed/expected ratio were assessed among four hospital categories according to the available BCS-G number. Finally, the impact of the hospital BCS-G number on mortality was evaluated. RESULTS: The ratio of BCS-G involvement ranged from 59.0 % for acute diffuse peritonitis to 89.1 % for hepatectomy, and the mortality rate was significantly lower for three procedures when BCS-Gs participated as the operator or assistant. The observed/expected ratio of hospitals with four or more BCS-Gs was less than 1.0 for all the procedures assessed. A multivariable logistic regression model showed that the hospital BCS-G number was a predictor of operative mortality. CONCLUSIONS: BCS-Gs contribute to favorable outcomes of gastroenterological surgery in Japan. The hospital BCS-G number is a surrogate marker of operative mortality.
PURPOSE: The aim of this study is to evaluate the association between the participation of board-certified surgeons in gastroenterological surgery (BCS-Gs) and the surgical outcomes of gastroenterological surgery. METHODS: Data from the National Clinical Database on patients who underwent eight major gastroenterological procedures were analyzed retrospectively. First, the ratio of cases in which BCS-G were involved to the total cases was calculated for each procedure, and the impact of BCS-G involvement on surgical outcome was assessed by comparing mortality rates in the group with BCS-G involvement vs. the group without BCS-G involvement. Second, the differences in the observed/expected ratio were assessed among four hospital categories according to the available BCS-G number. Finally, the impact of the hospital BCS-G number on mortality was evaluated. RESULTS: The ratio of BCS-G involvement ranged from 59.0 % for acute diffuse peritonitis to 89.1 % for hepatectomy, and the mortality rate was significantly lower for three procedures when BCS-Gs participated as the operator or assistant. The observed/expected ratio of hospitals with four or more BCS-Gs was less than 1.0 for all the procedures assessed. A multivariable logistic regression model showed that the hospital BCS-G number was a predictor of operative mortality. CONCLUSIONS: BCS-Gs contribute to favorable outcomes of gastroenterological surgery in Japan. The hospital BCS-G number is a surrogate marker of operative mortality.
Entities:
Keywords:
Board-certified surgeons in gastroenterological surgery; National Clinical Database; Operative mortality
Authors: Mahiben Maruthappu; Barnabas J Gilbert; Majd A El-Harasis; Myura Nagendran; Peter McCulloch; Antoine Duclos; Matthew J Carty Journal: Ann Surg Date: 2015-04 Impact factor: 12.969
Authors: Takayuki Anazawa; Jennifer L Paruch; Hiroaki Miyata; Mitsukazu Gotoh; Clifford Y Ko; Mark E Cohen; Norimichi Hirahara; Lynn Zhou; Hiroyuki Konno; Go Wakabayashi; Kenichi Sugihara; Masaki Mori Journal: Medicine (Baltimore) Date: 2015-12 Impact factor: 1.817