Hospital volume and surgical outcomes for elderly patients with colorectal cancer in the United States

Recent emphasis has been placed on the quality of surgical care in the United States. As such, patients, providers, and payers are increasingly aware of the outcomes of surgical care as a marker of quality. The objective of this study was to determine the impact of hospital volume on mortality for p...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:The Journal of surgical research 2003-09, Vol.114 (1), p.50-56
Hauptverfasser: Dimick, Justin B, Cowan, John A, Upchurch, Gilbert R, Colletti, Lisa M
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 56
container_issue 1
container_start_page 50
container_title The Journal of surgical research
container_volume 114
creator Dimick, Justin B
Cowan, John A
Upchurch, Gilbert R
Colletti, Lisa M
description Recent emphasis has been placed on the quality of surgical care in the United States. As such, patients, providers, and payers are increasingly aware of the outcomes of surgical care as a marker of quality. The objective of this study was to determine the impact of hospital volume on mortality for patients of different age groups to determine whether elderly patients would derive more benefit from selective referral policies. Data from the Nationwide Inpatient Sample for all patients undergoing surgery for colorectal cancer during 1997 were obtained ( N = 20,862). Differences in mortality associated with increasing age and hospital volume quartiles were determined. Risk-adjusted analyses of mortality were performed using multiple logistic regression. The overall mortality rate was 3.1% for the 842 hospitals included. Patient age breakdown was the following: age 80, 22%. Increasing age was associated with higher mortality rates: age 80, 6.9%. Overall, the highest volume hospitals (HVH) (>150/year) had lower mortality than the lowest volume hospitals (LVH) (
doi_str_mv 10.1016/S0022-4804(03)00207-5
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_73679304</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0022480403002075</els_id><sourcerecordid>73679304</sourcerecordid><originalsourceid>FETCH-LOGICAL-c391t-34b6ebff4dc5c410c5f8a134740de0f1d9fd5b755820c16571baff3c146c4f2d3</originalsourceid><addsrcrecordid>eNqFkUtv1DAQgC0EotvCTyjyBVQOofbajpMTQlUfSJU4tD1bznjcGiXxYjut-u_xdlf0yMka65vXN4Qcc_aNM96e3jC2XjeyY_KEia81YLpRb8iKs141XavFW7L6hxyQw5x_sxr3WrwnB1y0umv7bkX8VcybUOxIH-O4TEjt7Ghe0n2A-heXAnHCTH1MFEeHaXymG1sCziXTp1AeKMQxJoRtBbAzYKJhpuUB6d0cCjp6U2zB_IG883bM-HH_HpG7i_Pbs6vm-tflz7Mf1w2InpdGyKHFwXvpQIHkDJTvLBdSS-aQee5679SglerWDHirNB-s9wK4bEH6tRNH5Muu7ibFPwvmYqaQAcfRzhiXbHRdvBdMVlDtQEgx54TebFKYbHo2nJmtYPMi2GztGSbMi2Cjat6nfYNlmNC9Zu2NVuDzHrC5KvSpSgn5lVP1QFqLyn3fcVh1PAZMJkPVCujCVqdxMfxnlL97sZkT</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>73679304</pqid></control><display><type>article</type><title>Hospital volume and surgical outcomes for elderly patients with colorectal cancer in the United States</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Dimick, Justin B ; Cowan, John A ; Upchurch, Gilbert R ; Colletti, Lisa M</creator><creatorcontrib>Dimick, Justin B ; Cowan, John A ; Upchurch, Gilbert R ; Colletti, Lisa M</creatorcontrib><description>Recent emphasis has been placed on the quality of surgical care in the United States. As such, patients, providers, and payers are increasingly aware of the outcomes of surgical care as a marker of quality. The objective of this study was to determine the impact of hospital volume on mortality for patients of different age groups to determine whether elderly patients would derive more benefit from selective referral policies. Data from the Nationwide Inpatient Sample for all patients undergoing surgery for colorectal cancer during 1997 were obtained ( N = 20,862). Differences in mortality associated with increasing age and hospital volume quartiles were determined. Risk-adjusted analyses of mortality were performed using multiple logistic regression. The overall mortality rate was 3.1% for the 842 hospitals included. Patient age breakdown was the following: age &lt;50, 7%; age 50 to 64, 19%; age 65 to 80, 51%; and age &gt;80, 22%. Increasing age was associated with higher mortality rates: age &lt;50, 0.8%; age 51 to 65, 1.3%; age 66 to 80, 2.9%; and &gt;80, 6.9%. Overall, the highest volume hospitals (HVH) (&gt;150/year) had lower mortality than the lowest volume hospitals (LVH) (&lt;55/year) (2.5% vs. 3.7%; P = 0.006). However, the effect of volume on mortality was primarily due to differences in older patients. For patients greater than 65 years old, the mortality rate was 3.1% at HVH and 4.5% at LVH ( P = 0.03). For patients greater than 80 years old, the mortality rate was 4.6% at HVH and 7.3% at LVH ( P = 0.04). The results were unchanged after adjustment for patient demographics, comorbid disease, site of cancer, and type of resection. The majority of deaths after surgery for colorectal cancer occur in older patients. Hospitals that perform higher volumes of colorectal resection have lower mortality rates, especially for older patients. In the absence of other information about the quality of surgical care, provider volumes are a useful marker of postoperative outcomes for older patients in need of surgery for colorectal cancer.</description><identifier>ISSN: 0022-4804</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1016/S0022-4804(03)00207-5</identifier><identifier>PMID: 13678698</identifier><identifier>CODEN: JSGRA2</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Age Factors ; Aged ; Aged, 80 and over ; Analysis. Health state ; Biological and medical sciences ; Colectomy - mortality ; Colectomy - statistics &amp; numerical data ; colon cancer ; Colorectal Neoplasms - mortality ; Colorectal Neoplasms - surgery ; elderly ; Epidemiology ; Female ; General aspects ; Hospital Mortality ; hospital volume ; Humans ; Male ; Medical sciences ; Middle Aged ; mortality ; Outcome and Process Assessment (Health Care) ; outcomes ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Quality of Health Care ; regionalization ; surgery ; Surgery Department, Hospital - standards ; Surgery Department, Hospital - statistics &amp; numerical data ; Treatment Outcome ; United States - epidemiology</subject><ispartof>The Journal of surgical research, 2003-09, Vol.114 (1), p.50-56</ispartof><rights>2003 Elsevier Inc.</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c391t-34b6ebff4dc5c410c5f8a134740de0f1d9fd5b755820c16571baff3c146c4f2d3</citedby><cites>FETCH-LOGICAL-c391t-34b6ebff4dc5c410c5f8a134740de0f1d9fd5b755820c16571baff3c146c4f2d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0022-4804(03)00207-5$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27922,27923,45993</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=15109773$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/13678698$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dimick, Justin B</creatorcontrib><creatorcontrib>Cowan, John A</creatorcontrib><creatorcontrib>Upchurch, Gilbert R</creatorcontrib><creatorcontrib>Colletti, Lisa M</creatorcontrib><title>Hospital volume and surgical outcomes for elderly patients with colorectal cancer in the United States</title><title>The Journal of surgical research</title><addtitle>J Surg Res</addtitle><description>Recent emphasis has been placed on the quality of surgical care in the United States. As such, patients, providers, and payers are increasingly aware of the outcomes of surgical care as a marker of quality. The objective of this study was to determine the impact of hospital volume on mortality for patients of different age groups to determine whether elderly patients would derive more benefit from selective referral policies. Data from the Nationwide Inpatient Sample for all patients undergoing surgery for colorectal cancer during 1997 were obtained ( N = 20,862). Differences in mortality associated with increasing age and hospital volume quartiles were determined. Risk-adjusted analyses of mortality were performed using multiple logistic regression. The overall mortality rate was 3.1% for the 842 hospitals included. Patient age breakdown was the following: age &lt;50, 7%; age 50 to 64, 19%; age 65 to 80, 51%; and age &gt;80, 22%. Increasing age was associated with higher mortality rates: age &lt;50, 0.8%; age 51 to 65, 1.3%; age 66 to 80, 2.9%; and &gt;80, 6.9%. Overall, the highest volume hospitals (HVH) (&gt;150/year) had lower mortality than the lowest volume hospitals (LVH) (&lt;55/year) (2.5% vs. 3.7%; P = 0.006). However, the effect of volume on mortality was primarily due to differences in older patients. For patients greater than 65 years old, the mortality rate was 3.1% at HVH and 4.5% at LVH ( P = 0.03). For patients greater than 80 years old, the mortality rate was 4.6% at HVH and 7.3% at LVH ( P = 0.04). The results were unchanged after adjustment for patient demographics, comorbid disease, site of cancer, and type of resection. The majority of deaths after surgery for colorectal cancer occur in older patients. Hospitals that perform higher volumes of colorectal resection have lower mortality rates, especially for older patients. In the absence of other information about the quality of surgical care, provider volumes are a useful marker of postoperative outcomes for older patients in need of surgery for colorectal cancer.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis. Health state</subject><subject>Biological and medical sciences</subject><subject>Colectomy - mortality</subject><subject>Colectomy - statistics &amp; numerical data</subject><subject>colon cancer</subject><subject>Colorectal Neoplasms - mortality</subject><subject>Colorectal Neoplasms - surgery</subject><subject>elderly</subject><subject>Epidemiology</subject><subject>Female</subject><subject>General aspects</subject><subject>Hospital Mortality</subject><subject>hospital volume</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>mortality</subject><subject>Outcome and Process Assessment (Health Care)</subject><subject>outcomes</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Quality of Health Care</subject><subject>regionalization</subject><subject>surgery</subject><subject>Surgery Department, Hospital - standards</subject><subject>Surgery Department, Hospital - statistics &amp; numerical data</subject><subject>Treatment Outcome</subject><subject>United States - epidemiology</subject><issn>0022-4804</issn><issn>1095-8673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtv1DAQgC0EotvCTyjyBVQOofbajpMTQlUfSJU4tD1bznjcGiXxYjut-u_xdlf0yMka65vXN4Qcc_aNM96e3jC2XjeyY_KEia81YLpRb8iKs141XavFW7L6hxyQw5x_sxr3WrwnB1y0umv7bkX8VcybUOxIH-O4TEjt7Ghe0n2A-heXAnHCTH1MFEeHaXymG1sCziXTp1AeKMQxJoRtBbAzYKJhpuUB6d0cCjp6U2zB_IG883bM-HH_HpG7i_Pbs6vm-tflz7Mf1w2InpdGyKHFwXvpQIHkDJTvLBdSS-aQee5679SglerWDHirNB-s9wK4bEH6tRNH5Muu7ibFPwvmYqaQAcfRzhiXbHRdvBdMVlDtQEgx54TebFKYbHo2nJmtYPMi2GztGSbMi2Cjat6nfYNlmNC9Zu2NVuDzHrC5KvSpSgn5lVP1QFqLyn3fcVh1PAZMJkPVCujCVqdxMfxnlL97sZkT</recordid><startdate>20030901</startdate><enddate>20030901</enddate><creator>Dimick, Justin B</creator><creator>Cowan, John A</creator><creator>Upchurch, Gilbert R</creator><creator>Colletti, Lisa M</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20030901</creationdate><title>Hospital volume and surgical outcomes for elderly patients with colorectal cancer in the United States</title><author>Dimick, Justin B ; Cowan, John A ; Upchurch, Gilbert R ; Colletti, Lisa M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c391t-34b6ebff4dc5c410c5f8a134740de0f1d9fd5b755820c16571baff3c146c4f2d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis. Health state</topic><topic>Biological and medical sciences</topic><topic>Colectomy - mortality</topic><topic>Colectomy - statistics &amp; numerical data</topic><topic>colon cancer</topic><topic>Colorectal Neoplasms - mortality</topic><topic>Colorectal Neoplasms - surgery</topic><topic>elderly</topic><topic>Epidemiology</topic><topic>Female</topic><topic>General aspects</topic><topic>Hospital Mortality</topic><topic>hospital volume</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>mortality</topic><topic>Outcome and Process Assessment (Health Care)</topic><topic>outcomes</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Quality of Health Care</topic><topic>regionalization</topic><topic>surgery</topic><topic>Surgery Department, Hospital - standards</topic><topic>Surgery Department, Hospital - statistics &amp; numerical data</topic><topic>Treatment Outcome</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dimick, Justin B</creatorcontrib><creatorcontrib>Cowan, John A</creatorcontrib><creatorcontrib>Upchurch, Gilbert R</creatorcontrib><creatorcontrib>Colletti, Lisa M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of surgical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dimick, Justin B</au><au>Cowan, John A</au><au>Upchurch, Gilbert R</au><au>Colletti, Lisa M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hospital volume and surgical outcomes for elderly patients with colorectal cancer in the United States</atitle><jtitle>The Journal of surgical research</jtitle><addtitle>J Surg Res</addtitle><date>2003-09-01</date><risdate>2003</risdate><volume>114</volume><issue>1</issue><spage>50</spage><epage>56</epage><pages>50-56</pages><issn>0022-4804</issn><eissn>1095-8673</eissn><coden>JSGRA2</coden><abstract>Recent emphasis has been placed on the quality of surgical care in the United States. As such, patients, providers, and payers are increasingly aware of the outcomes of surgical care as a marker of quality. The objective of this study was to determine the impact of hospital volume on mortality for patients of different age groups to determine whether elderly patients would derive more benefit from selective referral policies. Data from the Nationwide Inpatient Sample for all patients undergoing surgery for colorectal cancer during 1997 were obtained ( N = 20,862). Differences in mortality associated with increasing age and hospital volume quartiles were determined. Risk-adjusted analyses of mortality were performed using multiple logistic regression. The overall mortality rate was 3.1% for the 842 hospitals included. Patient age breakdown was the following: age &lt;50, 7%; age 50 to 64, 19%; age 65 to 80, 51%; and age &gt;80, 22%. Increasing age was associated with higher mortality rates: age &lt;50, 0.8%; age 51 to 65, 1.3%; age 66 to 80, 2.9%; and &gt;80, 6.9%. Overall, the highest volume hospitals (HVH) (&gt;150/year) had lower mortality than the lowest volume hospitals (LVH) (&lt;55/year) (2.5% vs. 3.7%; P = 0.006). However, the effect of volume on mortality was primarily due to differences in older patients. For patients greater than 65 years old, the mortality rate was 3.1% at HVH and 4.5% at LVH ( P = 0.03). For patients greater than 80 years old, the mortality rate was 4.6% at HVH and 7.3% at LVH ( P = 0.04). The results were unchanged after adjustment for patient demographics, comorbid disease, site of cancer, and type of resection. The majority of deaths after surgery for colorectal cancer occur in older patients. Hospitals that perform higher volumes of colorectal resection have lower mortality rates, especially for older patients. In the absence of other information about the quality of surgical care, provider volumes are a useful marker of postoperative outcomes for older patients in need of surgery for colorectal cancer.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>13678698</pmid><doi>10.1016/S0022-4804(03)00207-5</doi><tpages>7</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0022-4804
ispartof The Journal of surgical research, 2003-09, Vol.114 (1), p.50-56
issn 0022-4804
1095-8673
language eng
recordid cdi_proquest_miscellaneous_73679304
source MEDLINE; Elsevier ScienceDirect Journals Complete
subjects Age Factors
Aged
Aged, 80 and over
Analysis. Health state
Biological and medical sciences
Colectomy - mortality
Colectomy - statistics & numerical data
colon cancer
Colorectal Neoplasms - mortality
Colorectal Neoplasms - surgery
elderly
Epidemiology
Female
General aspects
Hospital Mortality
hospital volume
Humans
Male
Medical sciences
Middle Aged
mortality
Outcome and Process Assessment (Health Care)
outcomes
Public health. Hygiene
Public health. Hygiene-occupational medicine
Quality of Health Care
regionalization
surgery
Surgery Department, Hospital - standards
Surgery Department, Hospital - statistics & numerical data
Treatment Outcome
United States - epidemiology
title Hospital volume and surgical outcomes for elderly patients with colorectal cancer in the United States
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-14T16%3A30%3A16IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Hospital%20volume%20and%20surgical%20outcomes%20for%20elderly%20patients%20with%20colorectal%20cancer%20in%20the%20United%20States&rft.jtitle=The%20Journal%20of%20surgical%20research&rft.au=Dimick,%20Justin%20B&rft.date=2003-09-01&rft.volume=114&rft.issue=1&rft.spage=50&rft.epage=56&rft.pages=50-56&rft.issn=0022-4804&rft.eissn=1095-8673&rft.coden=JSGRA2&rft_id=info:doi/10.1016/S0022-4804(03)00207-5&rft_dat=%3Cproquest_cross%3E73679304%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=73679304&rft_id=info:pmid/13678698&rft_els_id=S0022480403002075&rfr_iscdi=true