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Philip Baum
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P09 - Health Services Research/Health Economics - Real World Outcomes (ID 121)
- Event: WCLC 2020
- Type: Posters
- Track: Health Services Research/Health Economics
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P09.10 - Nationwide Effect of High Procedure Volume in Lung Cancer Surgery on In-House Mortality in Germany (ID 3695)
00:00 - 00:00 | Presenting Author(s): Philip Baum
- Abstract
Introduction
The literature reports that hospital caseload volume is associated with survival for lung cancer
resection. The aim of this study is to explore this association in a nationwide setting according
to individual hospital caseload volume of every inpatient case in Germany.
Methods
This retrospective analysis of nationwide hospital discharge data in Germany between 2013
and 2016 comprises 121837 patients of whom 36051 (29.5%) underwent surgical anatomic
resection. Hospital volumes were defined according to the number of patient resections for
lung cancer in each hospital, and patients were categorized into 5 quintiles based on hospital
caseload volume. A logistic regression model accounting for death according to sex, age,
comorbidity, and resection volume was calculated, and effect modification was evaluated
using the Mantel–Haenszel method.
Results
In-house mortality ranged from 2.1% in very high-volume centers to 4.0% in very low-volume
hospitals (p<0.01). In multivariable logistic regression analysis, lower in-house mortality in
very high-volume centers performing > 140 anatomic lung resections per year was compared
with very low-volume centers performing < 27 resections (OR, 0.58; CI, 0.46 to 0.72; p<0.01).
This relationship also held for failure to rescue rates (12.9 vs 16.7%, p=0.01), although a
greater number of extended resections were performed (23.1 vs. 14.8%, p<0.01).
Hospitals with high volumes of lung cancer resections performed surgery with a higher ratio
of complex procedures and achieved reduced in-house mortality, fewer complications, and
lower failure to rescue rate.