Evidence map›Paper›PMID 38937312›Full record

ArticleSurgical endoscopy2024

Hospital volume-outcome relationships for robot-assisted surgeries: a population-based analysis.

Richard J B Walker, Thérèse A Stukel, Charles de Mestral, Avery Nathens, Rodney H Breau, Waël C Hanna, Laura Hopkins, Christopher M Schlachta, Timothy D Jackson, Bobby Shayegan and 2 more

Abstract read
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Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

12 authors.

Richard J B WalkerDivision of General Surgery, Department of Surgery, University of Toronto, Toronto, Canada.
Thérèse A StukelInstitute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Charles de MestralInstitute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Avery NathensDivision of General Surgery, Department of Surgery, University of Toronto, Toronto, Canada.
Rodney H BreauDivision of Urology, Department of Surgery, University of Ottawa, Ottawa, Canada.
Waël C HannaDivision of Thoracic Surgery, Department of Surgery, McMaster University, Hamilton, Canada.
Laura HopkinsDivision of Oncology, Saskatchewan Cancer Agency, Saskatoon, Canada.
Christopher M SchlachtaDivision of General Surgery, Department of Surgery, Western University, London, Canada.
Timothy D JacksonDivision of General Surgery, Department of Surgery, University of Toronto, Toronto, Canada.
Bobby ShayeganJuravinski Cancer Centre, McMaster University, Hamilton, Canada.
Stephen E PautlerDivisions of Urology and Surgical Oncology, Departments of Surgery and Oncology, Western University, London, Canada.
Paul J KaranicolasDivision of General Surgery, Department of Surgery, University of Toronto, Toronto, Canada. paul.karanicolas@sunnybrook.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAssociations between procedure volumes and outcomes can inform minimum volume standards and the regionalization of health services. Robot-assisted surgery continues to expand globally; however, data are limited regarding which hospitals should be using the technology. STUDY

designUsing administrative health data for all residents of Ontario, Canada, this retrospective cohort study included adult patients who underwent a robot-assisted radical prostatectomy (RARP), total robotic hysterectomy (TRH), robot-assisted partial nephrectomy (RAPN), or robotic portal lobectomy using 4 arms (RPL-4) between January 2010 and September 2021. Associations between yearly hospital volumes and 90-day major complications were evaluated using multivariable logistic regression models adjusted for patient characteristics and clustering at the level of the hospital.

resultsA total of 10,879 patients were included, with 7567, 1776, 724, and 812 undergoing a RARP, TRH, RAPN, and RPL-4, respectively. Yearly hospital volume was not associated with 90-day complications for any procedure. Doubling of yearly volume was associated with a 17-min decrease in operative time for RARP (95% confidence interval [CI] - 23 to - 10), 8-min decrease for RAPN (95% CI - 14 to - 2), 24-min decrease for RPL-4 (95% CI - 29 to - 19), and no significant change for TRH (- 7 min; 95% CI - 17 to 3).

conclusionThe risk of 90-day major complications does not appear to be higher in low volume hospitals; however, they may not be as efficient with operating room utilization. Careful case selection may have contributed to the lack of an observed association between volumes and complications.

Indexed as

Hospitals, High-VolumeHospitals, Low-VolumeNephrectomyPostoperative ComplicationsProstatectomyRobotic Surgical ProceduresAdultAgedFemaleHumansHysterectomyMaleMiddle AgedOntarioOperative TimeRetrospective StudiesLength of stayOperative timePostoperative complicationsRobotic surgical procedures

Identifiers

PMID38937312

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.