Posted on 02/08/2023 8:15:52 PM PST by ConservativeMind
A new paper finds that patients undergoing liver surgery fare better in higher-volume hospitals; their mortality rates are lower.
Liver surgery is the standard treatment for most patients with primary and secondary liver tumors. Although postoperative mortality after liver surgery is rare, lower than 5%, it can be as high as 20% depending on the specific surgical procedure and where doctors perform the surgery.
Hospital volume influences postoperative complications after complex digestive surgical procedures, but the relationship is unclear. While performing more surgeries may mean overworked staff and rushed procedures higher volume may also mean greater efficiency and greater staff experience. Until now researchers have not investigated the impact of transplant activity in a center on outcomes well.
Researchers here investigated records of more than 39,000 patients who underwent liver surgery in France. They included national data from the French national administrative prospective database, which included 88% of French hospitals performing liver surgery in total.
The researchers found that patients who had liver surgeries in hospitals that performed more than 25 such surgeries a year were less likely to die after the surgery, either in the hospital immediately following the surgery or within six months of the procedure.
Among 39, 286 patients included, the in-hospital mortality rate was 2.8%, with 1090 deaths. While patients in high-volume hospitals were more likely to suffer from infections after the procedures (14.8% vs. 12.7% in lower-volume hospitals), they were less likely to die, 2.6% vs. 3%. This was particularly true with regard to liver failure, biliary complications, and vascular complications.
The researchers here believe that higher-volume medical centers are better at managing complications from liver operations "Liver surgery is safer in high-volume medical centers," said Josephine Magnin. This is likely due to better technical equipment and dedicated multidisciplinary teams in these establishments.
(Excerpt) Read more at medicalxpress.com ...
When you have nearly any kind of surgery or procedure, the best metric immediately at hand to determine the likelihood of a successful medical result is:
What volume of a procedure do they do annually?
It is simply common sense: A place that does a huge number of hip replacements a year will see variants of anatomy, surgical procedures, and dangerous complications that a smaller community hospital doing far fewer would ever see.
It isn't bulletproof, but if I had to make a snap decision with one easily derived metric, that is the metric I would ask to see.
This may go back to the old saying of
“If you want something done quickly, ask a busy person.” Those who are both busy and successful have often figured out how to approach their job in a prioritized and organized manner.
Too much leisure or down time can lead to sloth, indecision and lack of self confidence.
Flying in high performance aircraft necessitates getting as close to the edge of the envelope as you can, not just in the pilot skill, but in the design of the planes which often have single engines. When those single engines stop working, you don't have that other engine on the other wing and things happen damned fast.
So, like choosing a former fighter pilot as my airline pilot, I will take someone who has a high volume of hip surgeries under their belt.
A better goal would be not need liver surgery.
Not a surprise.
The staff is more experienced
When it is an emergency one doesn’t have the lyxury of checking. You get what you get
I’ll drink to that.
That is a given.
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