Impact of hospital volume on clinical outcomes of endoscopic biliary drainage for acute cholangitis based on the Japanese administrative database associated with the diagnosis procedure combination system

• Published in: Journal of gastroenterology 2010-10, Vol.45 (10), p.1090-1096
• Main Authors: Murata, Atsuhiko, Matsuda, Shinya, Kuwabara, Kazuaki, Fujino, Yoshihisa, Kubo, Tatsuhiko, Fujimori, Kenji, Horiguchi, Hiromasa
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Acute Disease; Aged; Aged, 80 and over; Biliary Tract; Cholangitis - therapy; Colorectal Surgery; Databases, Factual; Drainage - adverse effects; Drainage - methods; Endoscopy, Gastrointestinal - methods; Female; Gastroenterology; Hepatology; Hospitals; Hospitals - statistics & numerical data; Humans; Japan; Length of Stay; Linear Models; Logistic Models; Male; Medical colleges; Medicine; Medicine & Public Health; Middle Aged; Original Article—Liver; Pancreas; Postoperative Complications - etiology; Retrospective Studies; Surgical Oncology; Treatment Outcome
• ISSN: 0944-1174; 1435-5922
• DOI: 10.1007/s00535-010-0257-x

Background We aimed to determine the relationship between hospital volume and the clinical outcomes of endoscopic biliary drainage for acute cholangitis, using the Japanese administrative database associated with the diagnosis procedure combination (DPC) system. Methods A total of 8698 patients with endoscopic biliary drainage were referred to 654 hospitals. We corrected patients’ data from the database to compare risk-adjusted length of stay (LOS) and drainage-related complications in relation to the hospital volume. Hospital volume was categorized into three groups based on number of cases during the study period: low-volume hospitals (LVHs; 32 cases). Results Significant variation in mean LOS was observed between hospital volume categories (26.8 ± 22.6 days in LVHs vs. 23.3 ± 21.5 days in MVHs vs. 19.7 ± 17.2 days in HVHs, P