부산대학교 도서관

Background Evidence for an association between hospital volume and outcomes for liver surgery is abundant. The current Dutch guideline requires a minimum volume of 20 annual procedures per centre. The aim of this study was to investigate the association between hospital volume and postoperative outcomes using data from the nationwide Dutch Hepato Biliary Audit. Methods This was a nationwide study in the Netherlands. All liver resections reported in the Dutch Hepato Biliary Audit between 2014 and 2017 were included. Annual centre volume was calculated and classified in categories of 20 procedures per year. Main outcomes were major morbidity (Clavien-Dindo grade IIIA or higher) and 30-day or in-hospital mortality. Results A total of 5590 liver resections were done across 34 centres with a median annual centre volume of 35 (i.q.r. 20-69) procedures. Overall major morbidity and mortality rates were 11*2 and 2*0 per cent respectively. The mortality rate was 1*9 per cent after resection for colorectal liver metastases (CRLMs), 1*2 per cent for non-CRLMs, 0*4 per cent for benign tumours, 4*9 per cent for hepatocellular carcinoma and 10*3 per cent for biliary tumours. Higher-volume centres performed more major liver resections, and more resections for hepatocellular carcinoma and biliary cancer. There was no association between hospital volume and either major morbidity or mortality in multivariable analysis, after adjustment for known risk factors for adverse events. Conclusion Hospital volume and postoperative outcomes were not associated. CAPTION(S): Table S1 Univariable and multivariable logistic regression model of patient, tumor, surgical and volume factors associated with mortality in the Dutch Hepato Billiary Audit between 2014 and 2017 Table S2 Minor liver resections: univariable and multivariable logistic regression model of patient, tumor, surgical and volume factors associated with major morbidity (CD 3 or higher) in the Dutch Hepato Billiary Audit between 2014 and 2017 Table S3 Major liver resections: univariable and multivariable logistic regression model of patient, tumor, surgical and volume factors associated with major morbidity (CD 3 or higher) in the Dutch Hepato Billiary Audit between 2014 and 2017 Table S4 Colorectal liver resections: univariable and multivariable logistic regression model of patient, tumor, surgical and volume factors associated with major morbidity (CD 3 or higher) in the Dutch Hepato Billiary Audit between 2014 and 2017 Table S5a Negative resections margins according to tumor type and hospital volume in the Dutch Hepato Billiary Audit between 2014 and 2017 Table S5b Negative resections margins of biliary tumor resections according to hospital volume in the Dutch Hepato Billiary Audit between 2014 and 2017 Byline: P. B. Olthof, A. K. E. Elfrink, E. Marra, E. J. T. Belt, P. B. van den Boezem, K. Bosscha, E. C. J. Consten, M. den Dulk, P. D. Gobardhan, J. Hagendoorn, T. N. T. van Heek, J. N. M. IJzermans, J. M. Klaase, K. F. D. Kuhlmann, W. K. G. Leclercq, M. S. L. Liem, E. R. Manusama, H. A. Marsman, J. S. D. Mieog, S. J. Oosterling, G. A. Patijn, W. te Riele, R.-J. Swijnenburg, H. Torrenga, P. van Duijvendijk, M. Vermaas, N. F. M. Kok, D. J. Grunhagen, M. G. H. Besselink, M. T. de Boer, C. I. Buis, T. M. van Gulik, F. J. H. Hoogwater, I. Q. Molenaar, C. H. C. Dejong, C. Verhoef