Hannah Lee1, Eun Jin Jang2, Ga Hee Kim3, Nam Joon Yi4, Dal Ho Kim3, Seokha Yoo1, Hyung Sang Row1, Chul-Woo Jung1, Seung-Young Oh4, Ho Geol Ryu1. 1. Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. 2. Department of Information Statistics, Andong National University, Gyeongsangbuk-do, Republic of Korea. 3. Department of Statistics, Kyungpook National University, Daegu, Republic of Korea. 4. Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Abstract
BACKGROUND: The purpose of this study was to evaluate whether institutional case-volume affects clinical outcomes after pediatric liver transplantation. METHODS: We conducted a nationwide retrospective cohort study using the database of Korean National Healthcare Insurance Service. Between January 2007 and December 2016, 521 pediatric liver transplantations were performed at 22 centers in Korea. Centers were categorized according to the average annual number of liver transplantations: >10, 1 to 10, and <1. RESULTS: In-hospital mortality rates in the high-, medium-, and low-volume centers were 5.8%, 12.5%, and 32.1%, respectively. After adjustment, in-hospital mortality was significantly higher in low-volume centers (adjusted odds ratio, 9.693; 95% confidence interval, 4.636-20.268; P < 0.001) and medium-volume centers (adjusted odds ratio, 3.393; 95% confidence interval, 1.980-5.813; P < 0.001) compared to high-volume centers. Long-term survival for up to 9 years was better in high-volume centers. CONCLUSIONS: Centers with higher case volume (>10 pediatric liver transplantations/y) had better outcomes after pediatric liver transplantation, including in-hospital mortality and long-term mortality, compared to centers with lower case volume (≤10 liver transplantations/y).
BACKGROUND: The purpose of this study was to evaluate whether institutional case-volume affects clinical outcomes after pediatric liver transplantation. METHODS: We conducted a nationwide retrospective cohort study using the database of Korean National Healthcare Insurance Service. Between January 2007 and December 2016, 521 pediatric liver transplantations were performed at 22 centers in Korea. Centers were categorized according to the average annual number of liver transplantations: >10, 1 to 10, and <1. RESULTS: In-hospital mortality rates in the high-, medium-, and low-volume centers were 5.8%, 12.5%, and 32.1%, respectively. After adjustment, in-hospital mortality was significantly higher in low-volume centers (adjusted odds ratio, 9.693; 95% confidence interval, 4.636-20.268; P < 0.001) and medium-volume centers (adjusted odds ratio, 3.393; 95% confidence interval, 1.980-5.813; P < 0.001) compared to high-volume centers. Long-term survival for up to 9 years was better in high-volume centers. CONCLUSIONS: Centers with higher case volume (>10 pediatric liver transplantations/y) had better outcomes after pediatric liver transplantation, including in-hospital mortality and long-term mortality, compared to centers with lower case volume (≤10 liver transplantations/y).
Authors: Mounika Kanneganti; Yuwen Xu; Yuan-Shung Huang; Eimear Kitt; Brian T Fisher; Peter L Abt; Elizabeth B Rand; Douglas E Schaubel; Therese Bittermann Journal: Liver Transpl Date: 2021-08-25 Impact factor: 5.799
Authors: Seung-Young Oh; Eun Jin Jang; Ga Hee Kim; Hannah Lee; Nam-Joon Yi; Seokha Yoo; Bo Rim Kim; Ho Geol Ryu Journal: PLoS One Date: 2021-08-05 Impact factor: 3.240