Evidence map›Paper›PMID 28342131›Full record

ArticleSurgical endoscopy2017

Volume and outcomes relationship in laparoscopic diaphragmatic hernia repair.

Matthew D Whealon, Juan J Blondet, John V Gahagan, Michael J Phelan, Ninh T Nguyen

Abstract read
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed.

  1. Article
  2. Clinical Volume and Perioperative Outcomes of Hiatal Hernia Repair Within the Society of Thoracic Surgeons-General Thoracic Surgery Database.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025
    Article
  3. Review
  4. Article
  5. Review
  6. Article
  7. Review
  8. Article
  9. Management of paraesophageal hernia review of clinical studies: timing to surgery, mesh use, fundoplication, gastropexy and other controversies.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2020
    Article
  10. Gastrostomy tube placement in neonates undergoing tracheostomy: an opportunity to coordinate care?Journal of perinatology : official journal of the California Perinatal Association · 2020
    Article
  11. Article
  12. Accreditation and certification requirements for hernia centers and surgeons: the ACCESS project.Hernia : the journal of hernias and abdominal wall surgery · 2019
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Matthew D WhealonDepartment of Surgery, University of California, Irvine School of Medicine, Irvine, 333 City Bldg. West, Suite 1600, Orange, CA, 92868, USA.
Juan J BlondetDepartment of Surgery, University of California, Irvine School of Medicine, Irvine, 333 City Bldg. West, Suite 1600, Orange, CA, 92868, USA.
John V GahaganDepartment of Surgery, University of California, Irvine School of Medicine, Irvine, 333 City Bldg. West, Suite 1600, Orange, CA, 92868, USA.
Michael J PhelanDepartment of Statistics, University of California, Irvine, Irvine, California, CA, USA.
Ninh T NguyenDepartment of Surgery, University of California, Irvine School of Medicine, Irvine, 333 City Bldg. West, Suite 1600, Orange, CA, 92868, USA. ninhn@uci.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is no published data regarding the relationship between hospital volume and outcomes in patients undergoing laparoscopic diaphragmatic hernia repair. We hypothesize that hospitals performing high case volume have improved outcomes compared to low-volume hospitals. MATERIALS AND

methodsWe reviewed the National Inpatient Sample (NIS) database between 2008 and 2012 for adults with the diagnosis of diaphragmatic hernia who underwent elective laparoscopic repair of diaphragmatic Hernia and/or Nissen fundoplication. Pediatric, emergent, and open cases were excluded. Main outcome measures included logistic regression analysis of factors predictive of in-hospital mortality and outcomes according to annual hospital case volume.

resultsA total of 31,228 laparoscopic diaphragmatic hernia operations were analyzed. The overall in-hospital mortality was 0.14%. Risk factors for higher in-hospital mortality included renal failure (AOR: 6.26; 95% CI: 2.48-15.78; p < 0.001), age>60 years (AOR: 5.06; 95% CI: 2.38-10.76; p < 0.001), and CHF (AOR: 3.80; 95% CI: 1.39-10.38; p = 0.009) while an incremental increase in volume of 10 cases/year (AOR: 0.89; 95% CI: 0.81-0.98; p = 0.019) and diabetes (AOR: 0.34; 95% CI: 0.12-0.93; p = 0.036) decreases mortality. There was a small but significant inverse relationship between hospital case volume and mortality with a 10% reduction in adjusted odds of in-hospital mortality for every increase in 10 cases per year. Using 10 cases per year as the volume threshold, low-volume hospitals (≤10 cases/year) had almost a twofold higher mortality compared to high-volume hospitals (0.23 vs. 0.12%, respectively, p = 0.02).

conclusionsThere was a small but significant inverse relationship between the hospitals' case volume and mortality in laparoscopic diaphragmatic hernia repair.

Indexed as

HerniorrhaphyLaparoscopyAdultAgedElective Surgical ProceduresFemaleHernia, DiaphragmaticHospital AdministrationHospital MortalityHospitals, High-VolumeHospitals, Low-VolumeHumansInpatientsMaleMiddle AgedRetrospective StudiesDiaphragmatic herniaHospital volumeLaparoscopic hiatal herniaOutcomes

Identifiers

PMID28342131

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.