Surgical specialty, surgical unit volume, and mortality after oesophageal cancer surgery
Leigh Y et al. - In a trial to investigate the effects of surgical specialty and volume on mortality after oesophagectomy, it was shown that pts treated by general surgeons in low-volume hospitals had worse mortality outcomes than those treated by general surgeons in high-volume hospitals or by cardiothoracic surgeons. This is important because a majority of pts who underwent oesophagectomy for cancer were in this high-mortality risk group. Methods- Hospital Episode Statistics for oesophagectomy were analyzed for cancer (n=9034 cases), linked to data from death certificates, in England from 1998 to 2003.
Results- After adjustment for pts' age, sex, and deprivation score, the odds ratio (OR) for death of general surgeons' (GS) pts, compared with cardiothoracic surgeons' (CTS) pts, was significantly high: 1.62 at 90 days.
- Odds ratio for high-volume GS pts was not significantly different from that for high-volume CTS pts.
- Odds ratio for low-volume GS pts vs high-volume CTS pts was significantly high: 1.72 at 30 days and 1.48 at 90 days.
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