オオタニ マコト   Otani Makoto
  大谷 誠
   所属   関連施設  産業保健データサイエンスセンター 産業保健データサイエンスセンター
   職種   助教
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Effect of hospital volume on outcomes of laparoscopic appendectomy for acute appendicitis: an observational study.
掲載誌名 正式名:Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
略  称:J Gastrointest Surg
ISSNコード:18734626/1091255X
掲載区分国外
巻・号・頁 19(5),897-904頁
著者・共著者 Murata Atsuhiko, Mayumi Toshihiko, Muramatsu Keiji, Ohtani Makoto, Matsuda Shinya
発行年月 2015/05
概要 BACKGROUND:This study investigated the effect of hospital volume on outcomes of laparoscopic appendectomy for acute appendicitis.METHODS:In total, 30,525 patients who underwent laparoscopic appendectomy for acute appendicitis were referred to 825 hospitals in Japan from 2010 to 2012. We compared appendectomy-related complications, length of stay (LOS), and medical costs in relation to hospital volume. For this study period, hospitals were categorized as low-volume hospitals (LVHs, <50 cases), medium-volume hospitals (MVHs, 50-100 cases), or high-volume hospitals (HVHs, >100 cases).RESULTS:Significant differences in appendectomy-related complications were observed among the LVHs, MVHs, and HVHs (6.9, 7.2, and 6.0 %, respectively; p = 0.001). Multiple logistic regression revealed that HVHs were associated with a lower relative risk of appendectomy-related complications than were LVHs and MVHs (odds ratio [OR], 0.84; 95 % confidence interval [CI], 0.74-0.95; p = 0.006). Multiple linear regression showed that HVHs were associated with shorter LOS and lower medical costs than were LVHs and MVHs. The unstandardized coefficient for LOS was -0.92 days (95 % CI, -1.07 to -0.78; p < 0.001), whereas that for medical costs was - $167.4 (95 % CI, -256.2 to -78.6; p < 0.001).CONCLUSIONS:Hospital volume was significantly associated with laparoscopic appendectomy outcomes.
DOI 10.1007/s11605-015-2746-y
PMID 25595310