Bibliographic Details
| Title: |
The volume-outcome relationship for endoscopic transsphenoidal pituitary surgery for benign neoplasm: analysis of an administrative dataset for England. |
| Authors: |
Gray, William K.1 (AUTHOR) william.gray5@nhs.net, Navaratnam, Annakan V.1,2 (AUTHOR), Rennie, Catherine2 (AUTHOR), Mendoza, Nigel2 (AUTHOR), Briggs, Tim W. R.1 (AUTHOR), Phillips, Nick1,3 (AUTHOR) |
| Source: |
British Journal of Neurosurgery. Feb2025, Vol. 39 Issue 1, p44-51. 8p. |
| Subject Terms: |
*REOPERATION, *NUMERIC databases, *HOSPITAL statistics, *TRUST, *BENIGN tumors |
| Abstract: |
Background: Setting minimum annual volume thresholds for pituitary surgery in England is seen as one way of improving outcomes for patients and service efficiency. However, there are few recent studies from the UK on whether a volume-outcome effect exists, particularly in the era of endoscopic surgery. Such data are needed to allow evidence-based decision making. The aim of this study was to use administrative data to investigate volume-outcome effects for endoscopic transsphenoidal pituitary surgery in England. Methods: Data from the Hospital Episodes Statistics database for adult endoscopic transsphenoidal pituitary surgery for benign neoplasm conducted in England from April 2013 to March 2019 (inclusive) were extracted. Annual surgeon and trust volume was defined as the number of procedures conducted in the 12 months prior to the index procedure. Volume was categorised as < 10, 10–19, 20–29, 30–39 and ≥40 procedures for surgeon volume and < 20, 20–39, 40–59, 60–79 and ≥80 procedures for trust volume. The primary outcome was repeat ETSPS during the index procedure or during a hospital admission within one-year of discharge from the index procedure. Results: Data were available for 4590 endoscopic transsphenoidal pituitary procedures. After adjustment for covariates, higher surgeon volume was significantly associated with reduced risk of repeat surgery within one year (odds ratio (OR) 0.991 (95% confidence interval (CI) 0.982–1.000)), post-procedural haemorrhage (OR 0.977 (95% CI 0.967–0.987)) and length of stay greater than the median (0.716 (0.597–0.859)). A higher trust volume was associated with reduced risk of post-procedural haemorrhage (OR 0.992 (95% CI 0.985–0.999)), but with none of the other patient outcomes studied. Conclusions: A surgeon volume-outcome relationship exists for endoscopic transsphenoidal pituitary surgery in England. [ABSTRACT FROM AUTHOR] |
|
Copyright of British Journal of Neurosurgery is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| Database: |
Academic Search Complete |
|
Full text is not displayed to guests. |
Login for full access.
|
