Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/20283
Title: Hospital lung surgery volume and patient outcomes.
Austin Authors: Thai, Alesha A;Stuart, E;Te Marvelde, L;Milne, R L;Knight, S ;Whitfield, K;Mitchell, Paul L R 
Affiliation: Department of Medical Oncology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Victoria, 3004, Australia
Cancer Strategy & Development, Department of Health and Human Services, 50 Lonsdale St, Melbourne, Victoria, 3000, Australia
Department of Surgery, Austin Health, Heidelberg, Victoria, Australia
Issue Date: Mar-2019
metadata.dc.date: 2019-01-10
Publication information: Lung cancer 2019; 129: 22-27
Abstract: There has been evidence of an association between patient outcomes and the number of surgeries performed at a hospital. To our knowledge, there are no Australian data on hospital cancer surgery volumes and patient outcomes. We evaluated the relationship between hospital non-small cell lung cancer (NSCLC) surgery volume and patient outcomes in Victoria. Patients with a primary diagnosis of NSCLC between 2008 and 2014 were identified in the Victorian Cancer Registry (n = 15,369), 3,420 (22%) of whom had lung cancer surgery. Primary outcome was death within 90 days of surgery and secondary outcomes included overall survival, use of postoperative ventilation and ≥24hours spent in ICU. Hospital volume was measured as the average number of lung surgeries performed per year, with quartiles Q1: 1-17, Q2: 18-34, Q3: 35-58 and Q4: 59 + . 57% (1,941/3,420) lung cancer patients underwent lobectomy, 38% (1,299/3,420) sub-lobar resection and 5% (180/3,420) pneumonectomy. The overall 90-day mortality after lung surgery was 3.5%, and was 2.6% and 4.5% for patients undergoing lobectomy and sub-lobar resection respectively. There was no difference in 90-day mortality and overall survival between low- and high-volume centres regardless of procedure. Patients operated on in lower volume centres had more admissions to ICU ≥24hours (Q1. 55% vs. Q4. 11%, p-trend <0.001). A higher proportion of patients attending private hospitals (19%) had an ASA score of 4 compared with patients attending a public hospital (9%). We observed no evidence of survival differences between lung cancer patients attending low- and high-volume hospitals for cancer surgery. A higher proportion of patients had an ICU admission ≥24hours in lower volume centres and there are a higher proportion of patients with an ASA score of 4 in private hospitals compared to public hospitals.
URI: http://ahro.austin.org.au/austinjspui/handle/1/20283
DOI: 10.1016/j.lungcan.2019.01.002
ORCID: 0000-0001-8966-7677
PubMed URL: 30797487
Type: Journal Article
Subjects: Non-small cell lung cancer
Outcomes
Surgery
Surgical volume
Survival
Appears in Collections:Journal articles

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