Relationship between volume and in-hospital mortality in digestive oncological surgery

Paloma Pérez-López, Marisa Baré, Ángel Touma-Fernández, Antonio Sarría-Santamera

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    6 Citations (Scopus)


    © 2015 AEC. Introduction: The results previously obtained in Spain in the study of the relationship between surgical caseload and in-hospital mortality are inconclusive. The aim of this study is to evaluate the volume-outcome association in Spain in the setting of digestive oncological surgery. Methods: An analytical, cross-sectional study was conducted with data from patients who underwent surgical procedures with curative intent of esophageal, gastric, colorectal and pancreatic neoplasms between 2006-2009 with data from the Spanish MBDS. In-hospital mortality was used as outcome variable. Control variables were patient, health care and hospital characteristics. Exposure variable was the number of interventions for each disease, dividing the hospitals in 3 categories: high volume (HV), mid volume (MV) and low volume (LV) according to the number of procedures. Results: An inverse, statistically significant relationship between procedure volume and in-hospital mortality was observed for both volume categories in both gastric (LV: OR = 1,50 [IC 95%: 1,28-1,76]; MV: OR = 1,49 (IC 95%: 1,28-1,74)) and colorectal (LV: OR = 1,44 [IC 95%: 1,33-1,55]; MV: OR = 1,24 [IC 95%: 1,15-1,33]) cancer surgery. In pancreatic procedures, this difference was only statistically significant between LV and HV categories (LV: OR = 1,89 [IC 95%: 1,29-2,75]; MV: OR = 1,21 [IC 95%: 0,82-1,79]). Esophageal surgery also showed an inverse relationship, which was not statistically significant (LV: OR = 1,89 [IC 95%: 0,98-3,64]; MV: OR = 1,05 [IC 95%: 0,50-2,21]). Conclusions: The results of this study suggest the existence in Spain of an inverse relationship between caseload and in-hospital mortality in digestive oncological surgery for the procedures analyzed.
    Original languageEnglish
    Pages (from-to)151-158
    JournalCirugia Espanola
    Issue number3
    Publication statusPublished - 1 Mar 2016


    • Colorectal cancer
    • Esophageal cancer
    • Gastric cancer
    • Gastrointestinal surgery
    • High-volume hospitals
    • In-hospital mortality
    • Low-volume hospitals
    • Pancreatic cancer


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