Effect of caseload on the short-term outcome of colon surgery: results of a multicenter study.
This prospective multicenter study investigated the effect of hospital caseload on early postoperative outcome of surgery for carcinoma of the colon in 75 German hospitals and included 2293 patients. The hospitals were divided into those with a caseload of 1-30 (group A), 31-60 (group B), and more than 60 (group C) operations. Increasing caseload was associated only with fewer general postoperative complications. It was also associated with significantly greater use of antibiotic prophylaxis. No significant differences between the groups were found in resection rates, intraoperative complications, specific postoperative complications, overall postoperative morbidity, hospital mortality, or 30-day mortality. The significance of hospital caseload for the short-term postoperative outcome following surgery on the colon should not be overestimated. Basing conclusions about the results to be expected simply on the case volume is impermissible. On the basis of the available data it is not possible to establish a threshold value, that is, a minimum number of required operations.
Marusch
F
F
Institute for Quality Management in Operative Medicine, Otto-von-Guericke University, Magdeburg, Germany. marusch-cottbus@t-online.de
Koch
A
A
Schmidt
U
U
Zippel
R
R
Lehmann
M
M
Czarnetzki
H D
HD
Knoop
M
M
Geissler
S
S
Pross
M
M
Gastinger
I
I
Lippert
H
H
D000230:Adenocarcinoma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D011184:Postoperative Period; D011336:Probability; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D016526:Workload / Q000706:statistics & numerical data*