Volume-outcome relation for acute appendicitis: evidence from a nationwide population-based study.

<h4>Background</h4>Although procedures like appendectomy have been studied extensively, the relative importance of each surgeon's surgical volume-to-ruptured appendicitis has not been explored. The purpose of this study was to investigate the rate of ruptured appendicitis by surgeon...

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Autores principales:	Po-Li Wei, Shih-Ping Liu, Joseph J Keller, Herng-Ching Lin
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2055b8a1c82740659113d3de2e9bcc74
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spelling	oai:doaj.org-article:2055b8a1c82740659113d3de2e9bcc742021-11-18T08:03:40ZVolume-outcome relation for acute appendicitis: evidence from a nationwide population-based study.1932-620310.1371/journal.pone.0052539https://doaj.org/article/2055b8a1c82740659113d3de2e9bcc742012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23300703/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Although procedures like appendectomy have been studied extensively, the relative importance of each surgeon's surgical volume-to-ruptured appendicitis has not been explored. The purpose of this study was to investigate the rate of ruptured appendicitis by surgeon-volume groups as a measure of quality of care for appendicitis by using a nationwide population-based dataset.<h4>Methods</h4>We identified 65,339 first-time hospitalizations with a discharge diagnosis of acute appendicitis (International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes 540, 540.0, 540.1 and 540.9) between January 2007 and December 2009. We used "whether or not a patient had a perforated appendicitis" as the outcome measure. A conditional (fixed-effect) logistic regression model was performed to explore the odds of perforated appendicitis among surgeon case volume groups.<h4>Results</h4>Patients treated by low-volume surgeons had significantly higher morbidity rates than those treated by high-volume (28.1% vs. 26.15, p<0.001) and very-high-volume surgeons (28.1% vs. 21.4%, p<0.001). After adjusting for surgeon practice location, and teaching status of practice hospital, and patient age, gender, and Charlson Comorbidity Index, and hospital acute appendicitis volume, patients treated by low-volume surgeons had significantly higher rates of perforated appendicitis than those treated by medium-volume surgeons (OR = 1.09, p<0.001), high-volume surgeons (OR = 1.16, p<0.001), or very-high-volume surgeons (OR = 1.54, p<0.001).<h4>Conclusion</h4>Our study suggested that surgeon volume is an important factor with regard to the rate of ruptured appendicitis.Po-Li WeiShih-Ping LiuJoseph J KellerHerng-Ching LinPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 12, p e52539 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Po-Li Wei Shih-Ping Liu Joseph J Keller Herng-Ching Lin Volume-outcome relation for acute appendicitis: evidence from a nationwide population-based study.
description	<h4>Background</h4>Although procedures like appendectomy have been studied extensively, the relative importance of each surgeon's surgical volume-to-ruptured appendicitis has not been explored. The purpose of this study was to investigate the rate of ruptured appendicitis by surgeon-volume groups as a measure of quality of care for appendicitis by using a nationwide population-based dataset.<h4>Methods</h4>We identified 65,339 first-time hospitalizations with a discharge diagnosis of acute appendicitis (International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes 540, 540.0, 540.1 and 540.9) between January 2007 and December 2009. We used "whether or not a patient had a perforated appendicitis" as the outcome measure. A conditional (fixed-effect) logistic regression model was performed to explore the odds of perforated appendicitis among surgeon case volume groups.<h4>Results</h4>Patients treated by low-volume surgeons had significantly higher morbidity rates than those treated by high-volume (28.1% vs. 26.15, p<0.001) and very-high-volume surgeons (28.1% vs. 21.4%, p<0.001). After adjusting for surgeon practice location, and teaching status of practice hospital, and patient age, gender, and Charlson Comorbidity Index, and hospital acute appendicitis volume, patients treated by low-volume surgeons had significantly higher rates of perforated appendicitis than those treated by medium-volume surgeons (OR = 1.09, p<0.001), high-volume surgeons (OR = 1.16, p<0.001), or very-high-volume surgeons (OR = 1.54, p<0.001).<h4>Conclusion</h4>Our study suggested that surgeon volume is an important factor with regard to the rate of ruptured appendicitis.
format	article
author	Po-Li Wei Shih-Ping Liu Joseph J Keller Herng-Ching Lin
author_facet	Po-Li Wei Shih-Ping Liu Joseph J Keller Herng-Ching Lin
author_sort	Po-Li Wei
title	Volume-outcome relation for acute appendicitis: evidence from a nationwide population-based study.
title_short	Volume-outcome relation for acute appendicitis: evidence from a nationwide population-based study.
title_full	Volume-outcome relation for acute appendicitis: evidence from a nationwide population-based study.
title_fullStr	Volume-outcome relation for acute appendicitis: evidence from a nationwide population-based study.
title_full_unstemmed	Volume-outcome relation for acute appendicitis: evidence from a nationwide population-based study.
title_sort	volume-outcome relation for acute appendicitis: evidence from a nationwide population-based study.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/2055b8a1c82740659113d3de2e9bcc74
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Volume-outcome relation for acute appendicitis: evidence from a nationwide population-based study.

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