Urologist Caseload Volume May Affect Patient Outcome

Number of procedures performed is a possible quality indicator for transurethral resections of the prostate

TUESDAY, Aug. 19 (HealthDay News) -- Urologists who perform more transurethral resections of the prostate (TURP) may have lower rates of patient in-hospital mortality, according to an article published in the August issue of Urology.

Yi-Kuang Chen, of the Taipei Medical University in Taipei, Taiwan, and colleagues utilized data from the Taiwan National Health Insurance Research Database to examine the relationship between case volume for TURP and in-hospital mortality for the 9,539 procedures performed in 2003. Caseload volume was defined as low-, medium- or high-volume, and multivariate logistic regression was used to determine the relationship between TURP caseload volume and patient in-hospital mortality.

Overall, more experience was associated with declining in-hospital mortality rates: low-, medium- and high-volume TURP caseloads had in-hospital mortality rates of 2.37, 1.97 and 1.16 percent, respectively, the investigators found. In the multivariate logistic regression adjusting for patient, urologist and hospital characteristics, high caseloads were significantly associated with decreased in hospital mortality.

"Our results have demonstrated that patients treated by urologists performing a greater volume of procedures had lower in-hospital mortality than their counterparts treated by medium or lower TURP caseload-volume urologists, after adjusting for other factors," the authors write.

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