Evidence map›Paper›PMID 503167›Full record

ArticleThe New England journal of medicine1979

Should operations be regionalized? The empirical relation between surgical volume and mortality.

H S Luft, J P Bunker, A C Enthoven

Abstract read
PubMed Publisher
In one paragraph

Article in The New England journal of medicine, 1979. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 420 papers, 18 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
420citing papers in PubMed, 18 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

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

420 citing papers in PubMed, 18 syntheses or guidelines pooled it.

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  8. European Society of Coloproctology guideline on training in robotic colorectal surgery (2024).Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2024
    Guideline
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  19. Article
  20. Speaking Volumes About High-Volume Centers.Annals of surgical oncology · 2026
    Article

360 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors.

H S Luft
J P Bunker
A C Enthoven

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study examines mortality rates for 12 surgical procedures of varying complexity in 1498 hospitals to determine whether there is a relation between a hospital's surgical volume and its surgical mortality. The mortality of open-heart surgery, vascular surgery, transurethral resection of the prostate, and coronary bypass decreased with increasing number of operations. Hospitals in which 200 or more of these operations were done annually had death rates, adjusted for case mix, 25 to 41 per cent lower than hospitals with lower volumes. For other procedures, the mortality curve flattened at lower volumes. For example, hospitals doing 50 to 100 total hip replacements attained a mortality rate for this procedure almost as low as that of hospitals doing 200 or more. Some procedures, such as cholecystectomy, showed no relation between volume and mortality. The results may reflect the effect of volume or experience on mortality, or referrals to institutions with better outcomes, as well as a number of other factors, such as patient selection. Regardless of the explanation, these data support the value of regionalization for certain operations.

Indexed as

Statistics as TopicHospital DepartmentsHospital PlanningHospitals, GeneralHumansSurgery Department, HospitalSurgical Procedures, OperativeUnited States

Identifiers

PMID503167

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.