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Impact of Hospital and Surgeon Volumes in the Management of Complicated Portal Hypertension: Review of a Statewide Database in Florida
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Impact of Hospital and Surgeon Volumes in the Management of Complicated Portal Hypertension: Review of a Statewide Database in Florida
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Journal Article
Impact of Hospital and Surgeon Volumes in the Management of Complicated Portal Hypertension: Review of a Statewide Database in Florida
2010
Overview
Mortality after complex surgical procedures has been shown to be inversely related to hospital volume. The purpose of this study was to determine whether these findings are applicable to radiologic and surgical procedures for complicated portal hypertension. The Agency for Healthcare Administration for the State of Florida database was queried to determine outcomes after transjugular intrahepatic stent shunts (TIPS) or surgical shunts from 2000 to 2003. A total of 1486 patients underwent either TIPS (1321) or surgical shunts (165). Natural breakpoints occurred at two and six procedures per year were correlated with survival for surgical shunts but not TIPS. Overall mortality was not different between TIPS and surgical shunts (11.0 vs. 12.7%, P = 0.51); however, the cost of TIPS was significantly lower (62,000 ± 58.5 vs. 107,000 ± 97.8, P < 0.001) as well as the length of hospitalization (9 ± 9.0 days vs. 15 days ± 12.6 days, P < 0.001). Surgical procedures for complicated portal hypertension are rapidly being replaced by TIPS. Like with other complex procedures, outcomes are related to hospital volume.
Publisher
Southeastern Surgical Congress,SAGE PUBLICATIONS, INC
Subject
/ Biological and medical sciences
/ Female
/ Gastroenterology. Liver. Pancreas. Abdomen
/ Humans
/ Hypertension, Portal - complications
/ Hypertension, Portal - mortality
/ Hypertension, Portal - surgery
/ Liver. Biliary tract. Portal circulation. Exocrine pancreas
/ Male
/ Outcome Assessment (Health Care)
/ Portasystemic Shunt, Surgical - economics
/ Portasystemic Shunt, Surgical - mortality
/ Portasystemic Shunt, Surgical - statistics & numerical data
/ Portasystemic Shunt, Transjugular Intrahepatic - economics
/ Portasystemic Shunt, Transjugular Intrahepatic - mortality
/ Portasystemic Shunt, Transjugular Intrahepatic - statistics & numerical data
/ Public health. Hygiene-occupational medicine
/ Surgery Department, Hospital - statistics & numerical data
