Trends in Volume-Outcome Relationship in Surgery

NCT02788331 | Completed

• 1 other identifier: 69HCL16_0097
• Study Type: observational
• Target: 759,518
• Locations: 1 country
• Sites: 1

Brief Summary

The explanatory mechanism of the relationship between the volume of surgical procedures performed by individual hospitals and the occurrence of serious adverse events is not clear. Based on the " practice makes perfect " dogma, we will explore whether a learning effect can explain the volume-outcome relationship for complex surgical procedures using a nationwide dataset. Especially, we assume that increasing volume of procedures over time may be associated with improved outcomes.

Conditions

Surgical Procedures

Outcome Measures

Primary Outcomes (1)

• Inpatient mortality

  Within 30 days of surgical procedure

Secondary Outcomes (4)

• Reoperation occurence

  Within 30 days of surgical procedure

• Occurence of intensive or critical care unit stay

  Within 30 days of surgical procedure

• Occurence of postoperative complication

  Within 30 days of surgical procedure

• Occurence of unplanned hospital readmission

  Within 30 days of hospital discharge related to index stay

Study Arms (3)

Hospitals with increasing activity

Hospitals experiencing an increase in the volume of surgical procedures over the study period

Other: No intervention

Hospitals with decreasing activity

Hospitals experiencing a decrease in the volume of surgical procedures over the study period

Other: No intervention

Hospitals with stable activity

Hospitals experiencing no change in the volume of surgical procedures over the study period

Other: No intervention

Interventions

No intervention OTHER

Hospitals with decreasing activity; Hospitals with increasing activity; Hospitals with stable activity

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients operated in French public and private hospitals from January 2010 to December 2014

You may qualify if:

• All adults hospitalized to have one of the following major surgery: resection of oeso-gastric, intestinal and pancreatic cancer, treatment of intra-abdominal aortic aneurysm, coronary artery bypass graft, endarterectomy, hip fracture prosthesis

You may not qualify if:

• Hospitalization \<24 hours
• Absence of surgical procedure
• Ambulatory care
• Palliative care
• Organ transplantation

Sponsors & Collaborators

• Hospices Civils de Lyon: lead

Study Sites (1)

Pôle Information Médicale Evaluation Recherche des Hospices Civils de Lyon

Lyon, 69002, France

Location

Related Publications (1)

• Payet C, Polazzi S, Lifante JC, Cotte E, Grinberg D, Carty MJ, Sanchez S, Rabilloud M, Duclos A. Influence of trends in hospital volume over time on patient outcomes for high-risk surgery. BMC Health Serv Res. 2020 Apr 1;20(1):274. doi: 10.1186/s12913-020-05126-4.

  PMID: 32238160 DERIVED

Study Officials

• Antoine DUCLOS, MD, PhD

  Hospices Civils de Lyon

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 27, 2016
• First Posted: June 2, 2016
• Study Start: April 1, 2016
• Primary Completion: April 1, 2017
• Study Completion: April 1, 2017
• Last Updated: June 19, 2017

Record last verified: 2017-06

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)