ArticleJournal of the American College of Surgeons2019
Hospital Operative Volume as a Quality Indicator for General Surgery Operations Performed Emergently in Geriatric Patients
Article in Journal of the American College of Surgeons, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 28 citations in OpenAlex.
- Drowning in the silver tsunami: Geriatric patient proportion impact on trauma outcomes.Surgery · 2025Article
- Hospital experience with geriatric trauma impacts long-term survival.American journal of surgery · 2025Article
- Case volume and specialization in critically ill emergency patients: a nationwide cohort study in Japanese ICUs.Journal of intensive care · 2024Article
- [Consultations by senior physicians in general and abdominal surgery for other medical disciplines over 10 years at a tertiary center-Is a fast time-consuming processing necessary? : Spectrum of clinical findings, diagnoses and treatment decision making].Chirurgie (Heidelberg, Germany) · 2023Observational
- Impact of institutional case volume on intensive care unit mortality.Acute and critical care · 2023Article
- Impact of institutional case volume of solid organ transplantation on patient outcomes and implications for healthcare policy in Korea.Korean journal of transplantation · 2023Review
- No association between hospital volume and short-term outcomes of some common surgeries: a retrospective cohort study based on a Japanese nationwide database.Surgery today · 2022Article
- Benchmarking the value of care: Variability in hospital costs for common operations and its association with procedure volume.The journal of trauma and acute care surgery · 2020Article
Corrections and comments
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- Erratum issuedCorrection.2020
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundWithin the growing geriatric population, there is an increasing need for emergency operations. Optimizing outcomes can require a structured system of surgical care based on key quality indicators. To investigate this, the current study sought to answer 2 questions. First, to what degree does hospital emergency operative volume impact mortality for geriatric patients undergoing emergency general surgery (EGS) operations? Second, at what procedure-specific hospital volume will geriatric patients undergoing an emergency operation achieve at or better than average mortality risk? STUDY
designRetrospective cohort study of geriatric patients (aged 65 years and older) who underwent 1 of 10 EGS operations identified from the California State Inpatient Database (2010 to 2011). β-Logistic generalized linear regression was used, with the hospital as the unit of analysis, to investigate the relationship between hospital operative volume and in-hospital riskv-adjusted mortality. Hospital operative volume thresholds to optimize probability of survival were defined.
resultsThere were 41,860 operations evaluated at 299 hospitals. For each operation, mortality decreased as hospital emergency operative volume increased (p < 0.001 for each operation); for every standardized increase in volume (meaning +1 natural logarithm of volume), the reduction in mortality ranged from 14% for colectomy to 61% for appendectomy. Hospital volume thresholds, which optimize to 95% probability of survival, varied by procedure, with a mean of 14 operations over 2 years. More than 50% of hospitals did not meet the threshold benchmarks, representing 22% of patients.
conclusionsSurvival rates for geriatric patients were improved substantially when emergency operations were performed at hospitals with higher operative volumes. Consistent with all active Quality Programs of the American College of Surgeons, hospital operative volume appears to be an important metric of surgical quality for older patients undergoing emergency operations.
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