Hospital Volume Affects Liver Surgery Outcomes

Rates of in-hospital mortality, failure to rescue decreased from a hospital volume threshold of >25 liver resections per year

TUESDAY, Feb. 7, 2023 (HealthDay News) — The rates of in-hospital mortality and failure to rescue decrease from a hospital volume threshold of more than 25 liver resections per year, according to a study published online Feb. 2 in the British Journal of Surgery.

Josephine Magnin, from the University Hospital of Dijon in France, and colleagues conducted a retrospective study of patients who underwent liver resection between 2011 and 2019, and they calculated a threshold of surgical activities from which there were declines in in-hospital mortality.

The in-hospital mortality rate was 2.8 percent among 39,286 patients. The researchers found that the activity volume threshold was 25 hepatectomies, from which in-hospital mortality decreased. More postoperative complications were seen in high-volume centers (more than 25 resections per year), but they also had a lower rate of in-hospital mortality (2.6 versus 3 percent) and failure to rescue (5 versus 6.3 percent), in particular in relation to specific complications (liver failure, biliary complications, and vascular complications; 5.5 versus 7.6 percent). These outcomes were not affected by liver transplantation activity.

“Despite more major complications, in-hospital mortality and failure-to-rescue rates were lower in high-volume centers, in particular for minor hepatectomies. This implies that management of complications in high-volume centers is better,” the authors write.

Abstract/Full Text

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