ArticleBMC surgery2020
In-hospital mortality and failure to rescue following hepatobiliary surgery in Germany - a nationwide analysis.
Article in BMC surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Volume-outcome relationship in anatomical and non-anatomical liver resections: a rapid systematic review.BMC gastroenterology · 2026Pooled it
- Article
- Influence of Language Barriers on Postoperative Recovery After Hepatobiliary and Pancreatic Surgery: A Retrospective Analysis.World journal of surgery · 2026Article
- Risk Factors and Strategies for Failure to Rescue Following Hepatectomy: A Review.Journal of hepato-biliary-pancreatic sciences · 2025Review
- Textbook Outcome After Major Liver Resection for Primary and Secondary Liver Tumors at Specialized German Hepatobiliary Centers: Analysis of the StuDoQ Liver Registry.Annals of surgical oncology · 2025Article
- Failure to Rescue After Resection of Perhilar Cholangiocarcinoma in an International Multicenter Cohort.Annals of surgical oncology · 2025Article
- Results of robotic liver surgery in association with IWATE criteria - the first 100 cases.Langenbeck's archives of surgery · 2024Article
- [Robot-assisted visceral surgery in Germany : Analysis of the current status and trends of the last 5 years using data from the StuDoQ|Robotics registry].Chirurgie (Heidelberg, Germany) · 2023Article
- The failure to rescue factor: aftermath analyses on 224 cases of perihilar cholangiocarcinoma.Updates in surgery · 2023Article
- Nationwide volume-outcome relationship concerning in-hospital mortality and failure-to-rescue in surgery of sigmoid diverticulitis.International journal of colorectal disease · 2023Article
- Hepatobiliary surgery based on intelligent image segmentation technology.Open life sciences · 2023Article
- Hepatopancreaticobiliary Surgical Outcomes at a Community Hospital.Hawai'i journal of health & social welfare · 2022Article
- [Minimum case volumes from the perspective of university providers].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2022Review
- [Minimum volume requirements-perspective of a tertiary care hospital].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2022Review
- Pilonidal sinus disease on the rise: a one-third incidence increase in inpatients in 13 years with substantial regional variation in Germany.International journal of colorectal disease · 2021Article
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9 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundRecent observational studies on volume-outcome associations in hepatobiliary surgery were not designed to account for the varying extent of hepatobiliary resections and the consequential risk of perioperative morbidity and mortality. Therefore, this study aimed to determine the risk-adjusted in-hospital mortality for minor and major hepatobiliary resections at the national level in Germany and to examine the effect of hospital volume on in-hospital mortality, and failure to rescue.
methodsAll inpatient cases of hepatobiliary surgery (n = 31,114) in Germany from 2009 to 2015 were studied using national hospital discharge data. After ranking hospitals according to increasing hospital volumes, five volume categories were established based on all hepatobiliary resections. The association between hospital volume and in-hospital mortality following minor and major hepatobiliary resections was evaluated by multivariable regression methods.
resultsMinor hepatobiliary resections were associated with an overall mortality rate of 3.9% and showed no significant volume-outcome associations. In contrast, overall mortality rate of major hepatobiliary resections was 10.3%. In this cohort, risk-adjusted in-hospital mortality following major resections varied widely across hospital volume categories, from 11.4% (95% CI 10.4-12.5) in very low volume hospitals to 7.4% (95% CI 6.6-8.2) in very high volume hospitals (risk-adjusted OR 0.59, 95% CI 0.41-0.54). Moreover, rates of failure to rescue decreased from 29.38% (95% CI 26.7-32.2) in very low volume hospitals to 21.38% (95% CI 19.2-23.8) in very high volume hospitals.
conclusionsIn Germany, patients who are undergoing major hepatobiliary resections have improved outcomes, if they are admitted to higher volume hospitals. However, such associations are not evident following minor hepatobiliary resections. Following major hepatobiliary resections, 70-80% of the excess mortality in very low volume hospitals was estimated to be attributable to failure to rescue.
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