Hospital Volume Linked to Deaths After Cancer Surgery

Initiatives to improve long-term survival would have biggest impact on deaths

THURSDAY, June 26 (HealthDay News) -- Low-volume hospitals have higher perioperative and long-term mortality than high-volume hospitals for cancer surgery, although more deaths could be avoided by initiatives to improve long-term survival, according to a report published online June 23 in the Journal of Clinical Oncology.

Karl Y. Bilimoria, M.D., from Northwestern University in Chicago, and colleagues investigated the association between hospital surgical volume and perioperative mortality and long-term deaths using data from 243,103 patients who underwent surgery for non-metastatic colon, esophageal, gastric, liver, lung, pancreatic or rectal cancer.

The researchers found that lower hospital volumes were associated with higher perioperative (at 60 days) and long-term (at five years) mortality for all cancers except liver cancer. At low-volume hospitals, the risk of perioperative mortality was substantially higher than the risk of long-term mortality, but substantially more long-term deaths could have been avoided by improving outcomes to those observed at high-volume hospitals, the report indicates.

"Although the magnitude of the hazard ratios implies that quality-improvement efforts should focus on perioperative mortality, a larger number of deaths could be avoided by focusing quality initiatives on factors associated with long-term survival," Bilimoria and colleagues conclude.

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