The impact of the institutional abdominoperineal resections volume on short-term outcomes and expenses: a nationwide study

• Published in: Techniques in coloproctology 2023-08, Vol.27 (8), p.647-653
• Main Authors: Tustumi, Francisco, Portilho, Ana Sarah, Teivelis, Marcelo Passos, da Silva, Marcelo Fiorelli Alexandrino, Szor, Daniel José, Gerbasi, Lucas Soares, Pandini, Rafael Vaz, Seid, Victor Edmond, Wolosker, Nelson, Araujo, Sérgio Eduardo Alonso
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Colorectal cancer; Colorectal Surgery; Gastroenterology; Intensive care; Length of stay; Medicine; Medicine & Public Health; Mortality; Original Article; Patient admissions; Proctology; Public health; Surgery
• ISSN: 1123-6337; 1128-045X
• DOI: 10.1007/s10151-022-02733-7

Background The aim of this study was to evaluate the influence of the institutional volume of abdominoperineal resections (APR) on the short-term outcomes and costs in the Brazilian Public Health system. Methods This population-based study evaluated the number of APRs by institutions performed in the Brazilian Public Health system from January/2010 to July/2022. Data were extracted from a public domain from the Brazilian Public Health system. Results Four hundred and twelve hospitals performed APRs and were included. Only 23 performed at least 5 APRs per year on average and were considered high-volume institutions. The linear regression model showed that the number of hospital admissions for APRs was negatively associated with in-hospital mortality (Coef. = − 0.001; p  = 0.013) and length of stay in the intensive care unit (Coef. = − 0.006; p  = 0.01). The number of hospital admissions was not significantly associated with personnel, hospital, and total costs. The in-hospital mortality in high-volume institutions was significantly lower than in low-volume institutions (2.5 vs . 5.9%; p :