Effect of hospital volume on clinical outcome in patients with acute pancreatitis, based on a national administrative database

Atsuhiko Murata, Shinya Matsuda, Toshihiko Mayumi, Masamichi Yokoe, Kazuaki Kuwabara, Yukako Ichimiya, Yoshihisa Fujino, Tatsuhiko Kubo, Kenji Fujimori, Hiromasa Horiguchi

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39 Citations (Scopus)

Abstract

Objective: This study aimed to investigate the relationship between hospital volume and clinical outcome in patients with acute pancreatitis, using a Japanese national administrative database. Methods: A total of 7007 patients with acute pancreatitis were referred to776 hospitals in Japan. Patient data were corrected according to the severity of acute pancreatitis to allow the comparison of risk-adjusted in-hospital mortality and length of stay in relation to hospital volume. Hospital volume was categorized based on the number of cases during the study period into low-volume (<10 cases), medium-volume (10-16 cases), and high-volume hospitals (HVHs, >16 cases). Results: Increased hospital volume was significantly associated with decreased relative risk of in-hospital mortality in both patients with mild and those with severe acute pancreatitis. The odds ratios for HVHs were 0.424 (95% confidence interval [CI], 0.228-0.787; P = 0.007) and 0.338 (95% CI, 0.138-0.826; P = 0.017), respectively. Hospital volume was also significantly associated with shorter length of stay in patients with mild acute pancreatitis. The unstandardized coefficient for HVHs was -0.978 days (95% CI, -1.909 to -0.048; P = 0.039). Conclusions: This study demonstrated that hospital volume influences the clinical outcome in both patients with mild and those with severe acute pancreatitis.

Original languageEnglish
Pages (from-to)1018-1023
Number of pages6
JournalPancreas
Volume40
Issue number7
DOIs
Publication statusPublished - 2011 Oct 1
Externally publishedYes

Keywords

  • acute pancreatitis
  • administrative database
  • clinical outcome
  • hospital volume
  • severity

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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  • Cite this

    Murata, A., Matsuda, S., Mayumi, T., Yokoe, M., Kuwabara, K., Ichimiya, Y., Fujino, Y., Kubo, T., Fujimori, K., & Horiguchi, H. (2011). Effect of hospital volume on clinical outcome in patients with acute pancreatitis, based on a national administrative database. Pancreas, 40(7), 1018-1023. https://doi.org/10.1097/MPA.0b013e31821bd233