The impact of hospital volume on liver resection: A systematic review and Bayesian network meta-analysis.
Surgery
; 175(2): 393-403, 2024 02.
Article
in En
| MEDLINE
| ID: mdl-38052675
ABSTRACT
BACKGROUND:
This study aims to compare the outcomes of high-volume, medium-volume, and low-volume hospitals performing hepatic resections using a network meta-analysis.METHODS:
A literature search until June 2023 was conducted across major databases to identify studies comparing outcomes in high-volume, medium-volume, and low-volume hospitals for liver resection. Bayesian network meta-analysis was conducted, and surface under cumulative ranking area values, odds ratio, and mean difference with 95% credible intervals were reported for postoperative mortality, failure-to-rescue, morbidity, length of stay, and hospital costs.RESULTS:
Twenty studies comprising 248,707 patients undergoing liver resection were included. For the primary mortality outcome, overall and subgroup analyses were performed group I high-volume = 5 to 20 resections/year; group II high-volume = 21 to 49 resections/year; group III high-volume ≥50 resections/year. Results demonstrated a significant association between hospital volume and mortality (overall-high-volume versus medium-volume odds ratio 0.66, 95% credible interval 0.49-0.87; high-volume versus low-volume odds ratio 0.52, 95% credible interval 0.41-0.65; group I-high-volume versus low-volume odds ratio 0.34, 95% credible interval 0.22-0.50; medium-volume versus low-volume odds ratio 0.56, 95% credible interval 0.33-0.92; group II-high-volume versus low-volume odds ratio 0.67, 95% credible interval 0.45-0.91), as well as length of stay (high-volume versus low-volume mean difference -1.24, 95% credible interval -2.07 to -0.41), favoring high-volume hospitals. No significant difference was observed in failure-to-rescue, morbidity, or hospital costs across the 3 groups.CONCLUSION:
This study supports a positive relationship between hospital volume and surgical outcomes in liver resection. Patients from high-volume hospitals experience superior outcomes in terms of lower postoperative mortality and shorter lengths of stay than medium-volume and low-volume hospitals.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Hospitals, High-Volume
/
Hepatectomy
Type of study:
Systematic_reviews
Limits:
Humans
Language:
En
Journal:
Surgery
Year:
2024
Document type:
Article