Adrienne N Cobb1, Yee M Wong2, Sarah A Brownlee1, Barbara A Blanco3, Yoshiki Ezure3, Heather N Paddock4, Paul C Kuo5, Anai N Kothari1. 1. Loyola University Medical Center, Department of Surgery, Maywood, IL, USA; One:MAP Section of Surgical Analytics, Department of Surgery, Loyola University Chicago, USA. 2. Loyola University Medical Center, Department of Surgery, Maywood, IL, USA. 3. One:MAP Section of Surgical Analytics, Department of Surgery, Loyola University Chicago, USA. 4. Loyola University Medical Center, Department of Surgery, Maywood, IL, USA; Loyola University Medical Center, Department of Pediatrics, Maywood, IL, USA. 5. Loyola University Medical Center, Department of Surgery, Maywood, IL, USA; One:MAP Section of Surgical Analytics, Department of Surgery, Loyola University Chicago, USA. Electronic address: paul.kuo@luhs.org.
Abstract
BACKGROUND: This study examines the relationship between hospital volume of surgical cases for necrotizing enterocolitis (NEC) and patient outcomes. METHODS: A retrospective cross-sectional review was performed using the HCUP SID for California from 2007 to 2011. Patients with NEC who underwent surgery were identified using ICD-9CM codes. Risk-adjusted models were constructed with mixed-effects logistic regression using patient and demographic covariates. RESULTS: 23 hospitals with 618 patients undergoing NEC-related surgical intervention were included. Overall mortality rate was 22.5%. There were no significant differences in the number of NICU beds (p = 0.135) or NICU intensivists (p = 0.469) between high and low volume hospitals. Following risk adjustment, no difference in mortality rate was observed between high and low volume hospitals respectively (24.0% vs. 20.3%, p = 0.555). CONCLUSIONS: Our observation that neonates with NEC treated at low-volume centers have no increased risk of mortality may be explained by similar availability of NICU and intensivists resources across hospitals.
BACKGROUND: This study examines the relationship between hospital volume of surgical cases for necrotizing enterocolitis (NEC) and patient outcomes. METHODS: A retrospective cross-sectional review was performed using the HCUP SID for California from 2007 to 2011. Patients with NEC who underwent surgery were identified using ICD-9CM codes. Risk-adjusted models were constructed with mixed-effects logistic regression using patient and demographic covariates. RESULTS: 23 hospitals with 618 patients undergoing NEC-related surgical intervention were included. Overall mortality rate was 22.5%. There were no significant differences in the number of NICU beds (p = 0.135) or NICU intensivists (p = 0.469) between high and low volume hospitals. Following risk adjustment, no difference in mortality rate was observed between high and low volume hospitals respectively (24.0% vs. 20.3%, p = 0.555). CONCLUSIONS: Our observation that neonates with NEC treated at low-volume centers have no increased risk of mortality may be explained by similar availability of NICU and intensivists resources across hospitals.
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