Hospital volume, proportion resected and mortality from oesophageal and gastric cancer: a population-based study in England, 2004-2008
Hospital volume, proportion resected and mortality from oesophageal and gastric cancer: a population-based study in England, 2004-2008
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DOI：
10.1136/gutjnl-2012-303008
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发表时间：
2013-07-01
期刊：
影响因子：
24.5
通讯作者：
Moller, Henrik
中科院分区：
文献类型：
--
作者：
Coupland, Victoria H.;Lagergren, Jesper;Moller, Henrik
目的本研究评估了英格兰食管癌和胃癌患者的医院容量、切除率和生存率之间的关系。设计2004年至2008年期间，从全国人口为基础的癌症登记和医院事件统计相关数据集中确定了62 811例食管癌或胃癌患者。考克斯回归分析用于根据医院容量和切除率评估全因死亡率，调整病例组合变量（性别、年龄、社会经济剥夺、合并症和癌症类型）。根据医院容量，在术后3个预定时间段（365天）评价HR和95% CI。对所有患者和13189例（21%）切除患者进行了死亡率与切除率相关的分析。结果增加医院容量与降低死亡率相关（p（趋势）=0.0001; HR 0.87，95%CI 0.79至0.95，对于切除80+的医院，
Objective This study assessed the associations between hospital volume, resection rate and survival of oesophageal and gastric cancer patients in England.Design 62 811 patients diagnosed with oesophageal or gastric cancer between 2004 and 2008 were identified from a national population-based cancer registration and Hospital Episode Statistics-linked dataset. Cox regression analyses were used to assess all-cause mortality according to hospital volume and resection rate, adjusting for case-mix variables (sex, age, socioeconomic deprivation, comorbidity and type of cancer). HRs and 95% CIs, according to hospital volume, were evaluated for three predefined periods following surgery: 365 days. Analysis of mortality in relation to resection rate was performed among all patients and among the 13 189 (21%) resected patients.Results Increasing hospital volume was associated with lower mortality (p(trend)=0.0001; HR 0.87, 95% CI 0.79 to 0.95 for hospitals resecting 80+ and compared with