Abstract
We examined the impact of hospital volume on short-term outcomes after nephrectomy for nonmetastatic renal cell carcinoma. Using the Nationwide Inpatient Sample we identified 48,172 patients with nonmetastatic renal cell carcinoma treated with nephrectomy (1998 to 2007). Postoperative complications, blood transfusions, prolonged length of stay and in-hospital mortality were examined. Stratification was performed according to teaching status, nephrectomy type (partial vs radical nephrectomy) and surgical approach (open vs laparoscopic). Multivariable logistic regression models were fitted. Patients treated at high volume centers were younger and healthier at nephrectomy. High hospital volume predicted lower blood transfusion rates (8.5% vs 9.7% vs 11.8%), postoperative complications (14.4% vs 16.6% vs 17.2%) and shorter length of stay (43.1% vs 49.8% vs 54.0%, all p 0.05) and blood transfusions in nephrectomies performed laparoscopically (OR 0.68, p >0.05). On average, high hospital volume results in more favorable outcomes during hospitalization after nephrectomy.
| Original language | English |
|---|---|
| Pages (from-to) | 405-410 |
| Number of pages | 6 |
| Journal | Journal of Urology |
| Volume | 187 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Feb 2012 |
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Keywords
- carcinoma
- health facility size
- morbidity
- nephrectomy
- renal cell
- teaching
ASJC Scopus subject areas
- Urology
Cite this
Hospital volume is a determinant of postoperative complications, blood transfusion and length of stay after radical or partial nephrectomy. / Sun, Maxine; Bianchi, Marco; Trinh, Quoc Dien; Abdollah, Firas; Schmitges, Jan; Jeldres, Claudio; Shariat, Shahrokh F.; Graefen, Markus; Montorsi, Francesco; Perrotte, Paul; Karakiewicz, Pierre I.
In: Journal of Urology, Vol. 187, No. 2, 02.2012, p. 405-410.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hospital volume is a determinant of postoperative complications, blood transfusion and length of stay after radical or partial nephrectomy
AU - Sun, Maxine
AU - Bianchi, Marco
AU - Trinh, Quoc Dien
AU - Abdollah, Firas
AU - Schmitges, Jan
AU - Jeldres, Claudio
AU - Shariat, Shahrokh F.
AU - Graefen, Markus
AU - Montorsi, Francesco
AU - Perrotte, Paul
AU - Karakiewicz, Pierre I.
PY - 2012/2
Y1 - 2012/2
N2 - We examined the impact of hospital volume on short-term outcomes after nephrectomy for nonmetastatic renal cell carcinoma. Using the Nationwide Inpatient Sample we identified 48,172 patients with nonmetastatic renal cell carcinoma treated with nephrectomy (1998 to 2007). Postoperative complications, blood transfusions, prolonged length of stay and in-hospital mortality were examined. Stratification was performed according to teaching status, nephrectomy type (partial vs radical nephrectomy) and surgical approach (open vs laparoscopic). Multivariable logistic regression models were fitted. Patients treated at high volume centers were younger and healthier at nephrectomy. High hospital volume predicted lower blood transfusion rates (8.5% vs 9.7% vs 11.8%), postoperative complications (14.4% vs 16.6% vs 17.2%) and shorter length of stay (43.1% vs 49.8% vs 54.0%, all p 0.05) and blood transfusions in nephrectomies performed laparoscopically (OR 0.68, p >0.05). On average, high hospital volume results in more favorable outcomes during hospitalization after nephrectomy.
AB - We examined the impact of hospital volume on short-term outcomes after nephrectomy for nonmetastatic renal cell carcinoma. Using the Nationwide Inpatient Sample we identified 48,172 patients with nonmetastatic renal cell carcinoma treated with nephrectomy (1998 to 2007). Postoperative complications, blood transfusions, prolonged length of stay and in-hospital mortality were examined. Stratification was performed according to teaching status, nephrectomy type (partial vs radical nephrectomy) and surgical approach (open vs laparoscopic). Multivariable logistic regression models were fitted. Patients treated at high volume centers were younger and healthier at nephrectomy. High hospital volume predicted lower blood transfusion rates (8.5% vs 9.7% vs 11.8%), postoperative complications (14.4% vs 16.6% vs 17.2%) and shorter length of stay (43.1% vs 49.8% vs 54.0%, all p 0.05) and blood transfusions in nephrectomies performed laparoscopically (OR 0.68, p >0.05). On average, high hospital volume results in more favorable outcomes during hospitalization after nephrectomy.
KW - carcinoma
KW - health facility size
KW - morbidity
KW - nephrectomy
KW - renal cell
KW - teaching
UR - http://www.scopus.com/inward/record.url?scp=84855594584&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84855594584&partnerID=8YFLogxK
U2 - 10.1016/j.juro.2011.10.025
DO - 10.1016/j.juro.2011.10.025
M3 - Article
C2 - 22177151
AN - SCOPUS:84855594584
VL - 187
SP - 405
EP - 410
JO - Journal of Urology
JF - Journal of Urology
SN - 0022-5347
IS - 2
ER -