For Pulmonary Resection, Hospital Volume Impacts Mortality
(HealthDay News) — For patients undergoing major pulmonary resection for lung cancer, low annual hospital volume (AHV) is associated with increased 30-day and conditional 90-day mortality rates, according to a study presented at the annual meeting of the American Association for Thoracic Surgery, held from April 26–30 in Toronto.
Christopher M. Pezzi, MD, from the Abington Memorial Hospital in Pennsylvania, and colleagues examined the correlation between AHV and mortality rates for participants undergoing lobectomy, bi-lobectomy, or pneumonectomy from 2007–2011. Mortality rates were measured within 30 days, within 90 days, and between 30–90 days (conditional mortality).
The researchers identified 124,418 major pulmonary resections in 1,233 facilities, of which 121,099 and 118,290 had 30-day and 90-day mortality data available, respectively. The 30-day and conditional 90-day mortality rates were 2.8 and 2.6%, respectively. There was a significant correlation between AHV and 30-day mortality, with rates of 3.7% for volumes <10 and 1.7% for ≥90. The results were similar, although smaller differences persisted, for conditional 90-day mortality rates. In multivariate analysis, AHV remained significantly associated with 30-day and conditional 90-day mortality, with adjusted odds ratios of 2.1 and 1.3, respectively, for AHV of <10 vs. ≥90.
"This increase in the number of deaths between 30 days and 90 days after surgery was not expected and has not been extensively reported in the past," Pezzi said in a statement.