Hepatic resection in the United States - Indications, outcomes, and hospital procedural volumes from a nationally representative database
Hepatic resection in the United States - Indications, outcomes, and hospital procedural volumes from a nationally representative database
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DOI：
10.1001/archsurg.138.2.185
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发表时间：
2003-02-01
影响因子：
--
通讯作者：
Upchurch, GR
中科院分区：
文献类型：
--
作者：
Dimick, JB;Cowan, JA;Upchurch, GR
背景资料：肝切除术在美国已经成为常见的原发性和继发性肝肿瘤。假设：肝切除术后的结果变化与患者的特征，手术指征和医院手术量有关。设计：使用全国代表性数据库的观察性研究。患者：所有患者;在1996年和1997年的全国住院患者样本中，主要手术代码为肝切除（N = 2097）。主要结果测量：结果包括住院死亡率和住院时间。使用分层多变量模型进行风险调整分析。结果：2097例患者的总死亡率为5.8%。最常见的肝切除指征为继发性转移瘤（52%）、原发性肝脏恶性肿瘤（16%）、胆道恶性肿瘤（10%）和良性肝脏肿瘤（5%）。高流量医院的死亡率为3.9%，低流量医院为7.6%（P
Background: Hepatic resection has become common in the United States for both primary and secondary hepatic tumors.Hypothesis: Variation in outcomes after hepatic resection is related to patient characteristics, the indication for operation, and hospital procedural volume.Design: Observational study using a nationally representative database.Patients: All patients; in the Nationwide Inpatient Sample for 1996 and 1997 with a primary procedure code for hepatic resection (N = 2097).Main Outcome Measures: Outcomes included in-hospital mortality and length of stay. Risk-adjusted analyses were performed using hierarchical multivariate models.Results: Overall mortality for the 2097 patients was 5.8%. The most common indications for hepatic resection were secondary metastases (52%), primary hepatic malignancy (16%), biliary tract malignancy (10%), and benign hepatic tumor (5%). High-volume hospitals had a mortality rate of 3.9% vs 7.6% at low-volume hospitals (P