TÍTULO DE LA PUBLICACIÓN Publicado el 27/08/2009
In-hospital mortality after stomach cancer surgery in Spain and relationship with hospital volume of interventions
AUTORES
Baré M, Cabrol J, Real J, Navarro G, Campo R, Pericay C, Sarría A.
BACKGROUND:
There is no consensus about the possible relation between
in-hospital mortality in surgery for gastric cancer and the
hospital annual volume of interventions. The objectives were to
identify factors associated to greater in-hospital mortality for
surgery in gastric cancer and to analyze the possible independent
relation between hospital annual volume and in-hospital mortality.
METHODS:
We performed a retrospective cohort study of all patients
discharged after surgery for stomach cancer during 2001-2002 in
four regions of Spain using the Minimum Basic Data Set for Hospital
Discharges. The overall and specific in-hospital mortality rates
were estimated according to patient and hospital characteristics.
We adjusted a logistic regression model in order to calculate the
in-hospital mortality according to hospital volume.
RESULTS:
There were 3241 discharges in 144 hospitals. In-hospital
mortality was 10.3% (95% CI 9.3-11.4). A statistically significant
relation was observed among age, type of admission, volume, and
mortality, as well as diverse secondary diagnoses or the type of
intervention. Hospital annual volume was associated to Charlson
score, type of admission, region, length of stay and number of
secondary diagnoses registered at discharge. In the adjusted model,
increased age and urgent admission were associated to increased
in-hospital mortality. Likewise, partial gastrectomy (Billroth I
and II) and simple excision of lymphatic structure were associated
with a lower probability of in-hospital mortality. No independent
association was found between hospital volume and in-hospital
mortality
CONCLUSION:
Despite the limitations of our study, our results
corroborate the existence of patient, clinical, and intervention
factors associated to greater hospital mortality, although we found
no clear association between the volume of cases treated at a
centre and hospital mortality.
BMC Public Health. 2009 Aug 27;9:31