The influence of hospital volume on survival after resection for lung cancer Journal Article
| Authors: | Bach, P. B.; Cramer, L. D.; Schrag, D.; Downey, R. J.; Gelfand, S. E.; Begg, C. B. |
| Article Title: | The influence of hospital volume on survival after resection for lung cancer |
| Abstract: | Background: Among patients who have undergone high-risk operations for cancer, postoperative mortality rates are often lower at hospitals where more of these procedures are performed. We undertook a population-based study to estimate the extent to which the number of procedures performed at a hospital (hospital volume) is associated with survival after resection for lung cancer. Methods: We studied patients 65 years old or older who received a diagnosis of stage I, II, or IIIA non-small-cell lung cancer between 1985 and 1996, resided in 1 of the 10 study areas covered by the Surveillance, Epidemiology, and End Results Program, and underwent surgery at a hospital that participates in the Nationwide Inpatient Sample (2118 patients and 76 hospitals). Results: The volume of procedures at the hospital was positively associated with the survival of patients (P<0.001). Five years after surgery, 44 percent of patients who underwent operations at the hospitals with the highest volume were alive, as compared with 33 percent of those who underwent operations at the hospitals with the lowest volume. Patients at the highest-volume hospitals also had lower rates of postoperative complications (20 percent vs. 44 percent) and lower 30-day mortality (3 percent vs. 6 percent) than those at the lowest-volume hospitals. Conclusions: Patients who undergo resection for lung cancer at hospitals that perform large numbers of such procedures are likely to survive longer than patients who have such surgery at hospitals with a low volume of lung-resection procedures. Copyright © Massachusetts Medical Society. |
| Keywords: | cancer survival; aged; survival analysis; major clinical study; mortality; united states; lung resection; carcinoma, non-small-cell lung; lung neoplasms; pneumonectomy; lung cancer; postoperative complications; hospitals; survival time; utilization review; seer program; hospital admission; hospital mortality; humans; human; male; female; priority journal; article |
| Journal Title: | New England Journal of Medicine |
| Volume: | 345 |
| Issue: | 3 |
| ISSN: | 0028-4793 |
| Publisher: | Massachusetts Medical Society |
| Date Published: | 2001-07-19 |
| Start Page: | 181 |
| End Page: | 188 |
| Language: | English |
| DOI: | 10.1056/nejm200107193450306 |
| PUBMED: | 11463014 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 21 May 2015 -- Source: Scopus |
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