Impact of hospital volume on risk-adjusted mortality following oesophagectomy in Japan

T. Nishigori, Hiroaki Miyata, H. Okabe, Y. Toh, H. Matsubara, H. Konno, Y. Seto, Y. Sakai

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Previous studies have reported that patients undergoing oesophagectomy in high-volume hospitals experience lower mortality rates. However, there has been ongoing discussion regarding the validity of evidence for this association. The purpose of this study was to investigate the relationship between hospital volume and risk-adjusted mortality following oesophagectomy in Japan, using a nationwide web-based database. Methods: The study included patients registered in the database as having undergone oesophagectomy with reconstruction between 2011 and 2013. Outcome measures were 30-day and operative mortality rates. Logistic regression analysis was used to adjust for hospital volume, surgeon volume and risk factors for mortality after oesophagectomy. Results: A total of 16 556 oesophagectomies at 988 hospitals were included; the overall unadjusted 30-day and operative mortality rates were 1·1 and 3·0 per cent respectively. The unadjusted operative mortality rate in hospitals performing fewer than ten procedures per year (5·1 per cent) was more than three times higher than that in hospitals conducting 30 or more procedures annually (1·5 per cent). Multivariable models indicated that hospital volume had a significant effect on 30-day (odds ratio 0·88 per 10-patient increase; P = 0·012) and operative (odds ratio 0·86 per 10-patient increase; P < 0·001) mortality. Conclusion: In Japan, high-volume hospitals had lower risk-adjusted 30-day and operative mortality rates following oesophagectomy compared with low-volume hospitals.

Original languageEnglish
Pages (from-to)1880-1886
Number of pages7
JournalBritish Journal of Surgery
Volume103
Issue number13
DOIs
Publication statusPublished - 2016 Dec 1
Externally publishedYes

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Esophagectomy
Japan
Mortality
High-Volume Hospitals
Low-Volume Hospitals
Odds Ratio
Databases
Logistic Models
Regression Analysis
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Surgery

Cite this

Nishigori, T., Miyata, H., Okabe, H., Toh, Y., Matsubara, H., Konno, H., ... Sakai, Y. (2016). Impact of hospital volume on risk-adjusted mortality following oesophagectomy in Japan. British Journal of Surgery, 103(13), 1880-1886. https://doi.org/10.1002/bjs.10307

Impact of hospital volume on risk-adjusted mortality following oesophagectomy in Japan. / Nishigori, T.; Miyata, Hiroaki; Okabe, H.; Toh, Y.; Matsubara, H.; Konno, H.; Seto, Y.; Sakai, Y.

In: British Journal of Surgery, Vol. 103, No. 13, 01.12.2016, p. 1880-1886.

Research output: Contribution to journalArticle

Nishigori, T, Miyata, H, Okabe, H, Toh, Y, Matsubara, H, Konno, H, Seto, Y & Sakai, Y 2016, 'Impact of hospital volume on risk-adjusted mortality following oesophagectomy in Japan', British Journal of Surgery, vol. 103, no. 13, pp. 1880-1886. https://doi.org/10.1002/bjs.10307
Nishigori, T. ; Miyata, Hiroaki ; Okabe, H. ; Toh, Y. ; Matsubara, H. ; Konno, H. ; Seto, Y. ; Sakai, Y. / Impact of hospital volume on risk-adjusted mortality following oesophagectomy in Japan. In: British Journal of Surgery. 2016 ; Vol. 103, No. 13. pp. 1880-1886.
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