Nationwide in‐hospital mortality rate following rectal resection for rectal cancer according to annual hospital volume in Germany

• Published in: BJS open 2020-04, Vol.4 (2), p.310-319
• Main Authors: Diers, J., Wagner, J., Baum, P., Lichthardt, S., Kastner, C., Matthes, N., Matthes, H., Germer, C.‐T., Löb, S., Wiegering, A.
• Format: Article
• Language: English
• Subjects: Age; Aged; Aged, 80 and over; Codes; Colorectal cancer; Comorbidity; Data analysis; Female; Germany - epidemiology; Hospital Mortality - trends; Hospitals, High-Volume - statistics & numerical data; Hospitals, Low-Volume - statistics & numerical data; Humans; Logistic Models; Lower GI; Male; Middle Aged; Morbidity; Mortality; Original; Outcome Assessment, Health Care; Patients; Rectal Neoplasms - epidemiology; Rectal Neoplasms - mortality; Rectal Neoplasms - pathology; Rectal Neoplasms - surgery; Registries; Retrospective Studies; Surgeons; Trends
• ISSN: 2474-9842; 2474-9842
• DOI: 10.1002/bjs5.50254

Background The impact of hospital volume after rectal cancer surgery is seldom investigated. This study aimed to analyse the impact of annual rectal cancer surgery cases per hospital on postoperative mortality and failure to rescue. Methods All patients diagnosed with rectal cancer and who had a rectal resection procedure code from 2012 to 2015 were identified from nationwide administrative hospital data. Hospitals were grouped into five quintiles according to caseload. The absolute number of patients, postoperative deaths and failure to rescue (defined as in‐hospital mortality after a documented postoperative complication) for severe postoperative complications were determined. Results Some 64 349 patients were identified. The overall in‐house mortality rate was 3·9 per cent. The crude in‐hospital mortality rate ranged from 5·3 per cent in very low‐volume hospitals to 2·6 per cent in very high‐volume centres, with a distinct trend between volume categories (P