title: The Impact of Hospital/Surgeon Volume on Acute Renal Failure and Mortality in Liver Transplantation: A Nationwide Cohort Study.
abstract: The aim of this study was to assess whether the case volume of surgeons and hospitals affects the rates of postoperative complications and survival after liver transplantation. This population-based retrospective cohort study included 2938 recipients of liver transplantation performed between 1998 and 2012, enrolled from the Taiwan National Health Insurance Research Database. They were divided into two groups, according to the cumulative case volume of their operating surgeons and the case volume of their hospitals. The duration of intensive care unit stay and post-transplantation hospitalization, postoperative complications, and mortality were analyzed. The results showed that, in the low and high case volume surgeons groups, respectively, acute renal failure occurred at the rate of 14.11% and 5.86% (p<0.0001), and the overall mortality rates were 19.61% and 12.44% (p<0.0001). In the low and high case volume hospital groups, respectively, acute renal failure occurred in 11% and 7.11% of the recipients (p = 0.0004), and the overall mortality was 18.44% and 12.86% (p<0.0001). These findings suggest that liver transplantation recipients operated on higher case volume surgeons or in higher case volume hospitals have a lower rate of acute renal failure and mortality.
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
authors.forename: Chih-Wen
authors.initials: CW
authors.lastname: Cheng
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
authors.forename: Fu-Chao
authors.initials: FC
authors.lastname: Liu
authors.affiliation: Clinical Informatics and Medical Statistics Research Center and Graduate Institute of Clinical Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
authors.forename: Jr-Rung
authors.initials: JR
authors.lastname: Lin
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
authors.forename: Yung-Fong
authors.initials: YF
authors.lastname: Tsai
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
authors.forename: Hsiu-Pin
authors.initials: HP
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan.|College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
authors.forename: Huang-Ping
authors.initials: HP
authors.lastname: Yu
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000401:mortality*; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000209:etiology; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006760:Hospitalization; D061847:Hospitals, High-Volume; D006801:Humans; D007362:Intensive Care Units; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D017093:Liver Failure / Q000628:therapy; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology; D011183:Postoperative Complications; D012189:Retrospective Studies