Evidence map›Paper›PMID 31201494›Full record

ArticleWorld journal of surgery2019

Correlation Between the Increased Hospital Volume and Decreased Overall Perioperative Mortality in One Universal Health Care System.

Jin-Ming Wu, Te-Wei Ho, Yu-Wen Tien

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Article in World journal of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
–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

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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

8 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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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

3 authors.

Jin-Ming WuDepartment of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, 7 Chung-Shan South Rd., Taipei, 10002, Taiwan, ROC.
Te-Wei HoDepartment of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, 7 Chung-Shan South Rd., Taipei, 10002, Taiwan, ROC. skbaskba@gmail.com.
Yu-Wen TienDepartment of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, 7 Chung-Shan South Rd., Taipei, 10002, Taiwan, ROC. ywtien5106@ntu.edu.tw.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVolume-outcome relationship has been demonstrated extensively for short-term outcomes for oncological surgery. However, its effect on long-term surgical outcomes or in one universal health care (UHC) system is unknown. This retrospective population-based study aims to validate the correlation between the increased hospital volume and better short- and long-term outcomes in patients who underwent total gastrectomy (TG) for gastric cancer.

methodsFrom the Taiwan National Health Insurance Research Database, we examined 7905 patients who underwent TG between 2000 and 2010. The surgical outcomes of this study were defined as death within 30, 60, and 180 days after TG.

resultsA total of 7905 subjects were included for analysis. The mean age was 65.8 years, and 68.8% were males. The 30-, 60-, and 180-day mortality rates after TG for gastric cancer were 2.7%, 6.2%, and 18.2%, respectively. On the multivariate analysis, TG at high-volume hospitals significantly contributed to lower 30-day (odds ratio 0.64; 95% confidence interval 0.48-0.85; P < 0.001), 60-day (odds ratio 0.68; 95% confidence interval 0.56-0.82; P < 0.001), and 180-day mortality rates (odds ratio 0.80; 95% confidence interval 0.70-0.90; P < 0.001).

conclusionsAlthough TG is a complex operation with high mortality rates (~180-day), high hospital volume correlates with better perioperative outcomes even in UHC system. Hence, the strategy to advocate the centralization of TG is reasonable, especially for the elderly.

Indexed as

Hospitals, High-VolumeUniversal Health CareAgedAged, 80 and overFemaleGastrectomyHospital MortalityHumansMaleMiddle AgedRetrospective StudiesStomach NeoplasmsTaiwan

Identifiers

PMID31201494

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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.