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• Nieuwe publicatie – Relatie tussen ziekenhuisvolume en postoperatieve uitkomsten van leverchirurgie: een landelijke analyse

Vandaag is een nieuwe publicatie uitgebracht met data van de Dutch Hepato Biliary Audit (DHBA). Deze multidisciplinaire audit registreert de resultaten van verschillende behandelingen van levertumoren.

Olthof & Elfrink et al. hebben in hun manuscript met behulp van data uit de Dutch Hepato Biliary Audit gekeken naar de relatie tussen ziekenhuisvolume en postoperatieve uitkomsten. Het bleek dat er in Nederland geen duidelijke relatie hiertussen is, waarschijnlijk als gevolg van centralisatie van leverchirurgie in Nederland voor aanvang van deze studie.

Volume–outcome relationship of liver surgery: a nationwide analysis

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. Grünhagen,  Dutch Hepato Biliary Audit Group

Lees het volledige artikel hier: https://bjssjournals.onlinelibrary.wiley.com/doi/full/10.1002/bjs.11586

Zie hieronder de Engelse samenvatting:

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.