Anne Hendricks1, Johannes Diers1, Philip Baum2, Stephanie Weibel3, Carolin Kastner1, Sophie Müller1, Johan Friso Lock1, Franziska Köhler1, Patrik Meybohm3, Peter Kranke3, Christoph-Thomas Germer4, Armin Wiegering5. 1. Department of General, Visceral, Transplant, Vascular and Pediatric Surgery University Hospital Würzburg, Oberduerrbacherstrasse 6, 97080, Wuerzburg, Germany. 2. Department of General, Visceral, Transplant, Vascular and Pediatric Surgery University Hospital Würzburg, Oberduerrbacherstrasse 6, 97080, Wuerzburg, Germany; Department of Thoracic Surgery, Thoraxklinik at Heidelberg University Hospital, Roentgenstrasse 1, 69126, Heidelberg, Germany. 3. Clinic and Policlinic for Anesthesiology Surgery, University Hospital Würzburg, Germany. 4. Department of General, Visceral, Transplant, Vascular and Pediatric Surgery University Hospital Würzburg, Oberduerrbacherstrasse 6, 97080, Wuerzburg, Germany; Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Germany. 5. Department of General, Visceral, Transplant, Vascular and Pediatric Surgery University Hospital Würzburg, Oberduerrbacherstrasse 6, 97080, Wuerzburg, Germany; Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Germany; Department of Biochemistry and Molecular Biology University of Würzburg Würzburg, Germany. Electronic address: Wiegering_A@ukw.de.
Abstract
BACKGROUND: In the past, for a number of abdominal surgical interventions a correlation between treatment volume of a hospital and the patient's outcome was shown in national and international studies. METHODS: Based on a systematic literature search we analyzed the absolute and risk-adjusted in-house lethality as well as the rate of complications and the failure to rescue after abdominal surgery in Germany. The hospitals were grouped in quintiles according to the volume of treatment. RESULTS: 11 studies including more than 2 million patients were identified and surgeries for the treatment of 9 disease conditions were studied. The meta-analysis shows a significantly lower absolute and risk-adjusted in-house mortality for surgery in hospitals with high treatment volumes compared to low volume hospitals. In the context of subgroup analysis, this effect is demonstrated especially for complex surgical procedures. The failure to rescue in patients suffering from sepsis is significantly lower in high volume centers compared to low volume centers. CONCLUSION: This systematic review and meta-analysis shows on more than 2 million patients that there is a volume-outcome relationship for the surgical treatment of abdominal diseases in Germany across various organ systems, which is particularly true for complex interventions.
BACKGROUND: In the past, for a number of abdominal surgical interventions a correlation between treatment volume of a hospital and the patient's outcome was shown in national and international studies. METHODS: Based on a systematic literature search we analyzed the absolute and risk-adjusted in-house lethality as well as the rate of complications and the failure to rescue after abdominal surgery in Germany. The hospitals were grouped in quintiles according to the volume of treatment. RESULTS: 11 studies including more than 2 million patients were identified and surgeries for the treatment of 9 disease conditions were studied. The meta-analysis shows a significantly lower absolute and risk-adjusted in-house mortality for surgery in hospitals with high treatment volumes compared to low volume hospitals. In the context of subgroup analysis, this effect is demonstrated especially for complex surgical procedures. The failure to rescue in patients suffering from sepsis is significantly lower in high volume centers compared to low volume centers. CONCLUSION: This systematic review and meta-analysis shows on more than 2 million patients that there is a volume-outcome relationship for the surgical treatment of abdominal diseases in Germany across various organ systems, which is particularly true for complex interventions.
Authors: Armin Wiegering; Johanna Wagner; Philip Baum; Johannes Diers; Christoph-Thomas Germer; Ingo Klein Journal: Dtsch Arztebl Int Date: 2022-02-04 Impact factor: 5.594
Authors: Franziska Köhler; Lena Reese; Carolin Kastner; Anne Hendricks; Sophie Müller; Johan F Lock; Christoph-Thomas Germer; Armin Wiegering Journal: Front Surg Date: 2022-06-08
Authors: Martin Roessler; Felix Walther; Maria Eberlein-Gonska; Peter C Scriba; Ralf Kuhlen; Jochen Schmitt; Olaf Schoffer Journal: BMC Health Serv Res Date: 2022-01-02 Impact factor: 2.655
Authors: Konstantin L Uttinger; Maria Riedmeier; Joachim Reibetanz; Thomas Meyer; Christoph Thomas Germer; Martin Fassnacht; Armin Wiegering; Verena Wiegering Journal: Front Endocrinol (Lausanne) Date: 2022-07-27 Impact factor: 6.055