title: Population-based review of the outcomes following hepatic resection in a Canadian health region.
abstract: BACKGROUND
  Higher hospital and surgeon volumes have been associated with improved outcomes following hepatic resection; however, there appear to be additional factors that also play a role. The objective of our study was to examine the outcomes following hepatic resection over the past 13 years in a large urban Canadian health region.
  
  
  METHODS
  We used administrative procedure codes to identify all patients from 1991/92 to 2003/04 who underwent a hepatic resection in the Calgary health region, which has a referral base of about 1.5 million people. The primary outcome was operative mortality, defined as death before discharge.
  
  
  RESULTS
  There were 424 hepatic resections performed in the stated time period. Annual volume was stable until 2000, when it increased substantially. This corresponded to the formation of a multidisciplinary group that provided care to these patients. There were 25 deaths over the study period for a mean mortality of 5.9%. The mean length of stay in hospital was 14.6 (median 10) days. Over time, however, mortality steadily decreased. This corresponded to a concomitant increase in the volume of hepatic resections performed.
  
  
  CONCLUSIONS
  Over the past 13 years, the number of hepatic resections performed has increased; there has been a corresponding improvement in mortality rates. The improved rates are likely the result of multiple factors.
authors.affiliation: Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alta. elijah.dixon@calgaryhealthregion.ca
authors.forename: Elijah
authors.initials: E
authors.lastname: Dixon
authors.forename: Oliver F
authors.initials: OF
authors.lastname: Bathe
authors.forename: Andrew
authors.initials: A
authors.lastname: McKay
authors.forename: Isabelle
authors.initials: I
authors.lastname: You
authors.forename: Scot
authors.initials: S
authors.lastname: Dowden
authors.forename: David
authors.initials: D
authors.lastname: Sadler
authors.forename: Kelly W
authors.initials: KW
authors.lastname: Burak
authors.forename: J Gregory
authors.initials: JG
authors.lastname: McKinnon
authors.forename: Walter
authors.initials: W
authors.lastname: Miller
authors.forename: Francis R
authors.initials: FR
authors.lastname: Sutherland
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta; D002648:Child; D002675:Child, Preschool; D005260:Female; D006498:Hepatectomy / Q000401:mortality* / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008107:Liver Diseases / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D017063:Outcome Assessment, Health Care; D014505:Urban Population; D055815:Young Adult