Impact of Hospital Volume on the Outcomes of Renal Trauma Management.
Centralization
Complication
Hospital volume
Outcomes
Renal trauma
Journal
European urology open science
ISSN: 2666-1683
Titre abrégé: Eur Urol Open Sci
Pays: Netherlands
ID NLM: 101771568
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
accepted:
18
01
2022
entrez:
4
3
2022
pubmed:
5
3
2022
medline:
5
3
2022
Statut:
epublish
Résumé
Some health care systems have set up referral trauma centers to centralize expertise to improve trauma management. There is scant and controversial evidence regarding the impact of provider's volume on the outcomes of trauma management. To evaluate the impact of hospital volume on the outcomes of renal trauma management in a European health care system. A retrospective multicenter study, including all patients admitted for renal trauma in 17 French hospitals between 2005 and 2015, was conducted. Nephrectomy, angioembolization, or nonoperative management. Four quartiles according to the caseload per year: low volume (eight or fewer per year), moderate volume (nine to 13 per year), high volume (14-25/yr), and very high volume (≥26/yr). The primary endpoint was failure of nonoperative management defined as any interventional radiology or surgical procedure needed within the first 30 d after admission. Of 1771 patients with renal trauma, 1704 were included. Nonoperative management was more prevalent in the very-high- and low-volume centers ( In this multicenter study, management of renal trauma varied according to hospital volume. There were lower rates of nephrectomy and failure of nonoperative management in very-high-volume centers. These results raise the question of centralizing the management of renal trauma, which is currently not the case in our health care system. In this study, management of renal trauma varied according to hospital volume. Very-high-volume centers had lower rates of nephrectomy and failure of nonoperative management.
Sections du résumé
BACKGROUND
BACKGROUND
Some health care systems have set up referral trauma centers to centralize expertise to improve trauma management. There is scant and controversial evidence regarding the impact of provider's volume on the outcomes of trauma management.
OBJECTIVE
OBJECTIVE
To evaluate the impact of hospital volume on the outcomes of renal trauma management in a European health care system.
DESIGN SETTING AND PARTICIPANTS
METHODS
A retrospective multicenter study, including all patients admitted for renal trauma in 17 French hospitals between 2005 and 2015, was conducted.
INTERVENTION
METHODS
Nephrectomy, angioembolization, or nonoperative management.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS
METHODS
Four quartiles according to the caseload per year: low volume (eight or fewer per year), moderate volume (nine to 13 per year), high volume (14-25/yr), and very high volume (≥26/yr). The primary endpoint was failure of nonoperative management defined as any interventional radiology or surgical procedure needed within the first 30 d after admission.
RESULTS AND LIMITATIONS
CONCLUSIONS
Of 1771 patients with renal trauma, 1704 were included. Nonoperative management was more prevalent in the very-high- and low-volume centers (
CONCLUSIONS
CONCLUSIONS
In this multicenter study, management of renal trauma varied according to hospital volume. There were lower rates of nephrectomy and failure of nonoperative management in very-high-volume centers. These results raise the question of centralizing the management of renal trauma, which is currently not the case in our health care system.
PATIENT SUMMARY
RESULTS
In this study, management of renal trauma varied according to hospital volume. Very-high-volume centers had lower rates of nephrectomy and failure of nonoperative management.
Identifiants
pubmed: 35243394
doi: 10.1016/j.euros.2022.01.004
pii: S2666-1683(22)00019-2
pmc: PMC8883196
doi:
Types de publication
Journal Article
Langues
eng
Pagination
99-105Informations de copyright
© 2022 The Author(s).
Références
N Engl J Med. 2006 Jan 26;354(4):366-78
pubmed: 16436768
Prog Urol. 2019 Nov;29(15):936-942
pubmed: 31668829
BJU Int. 2016 Feb;117(2):226-34
pubmed: 25600513
Medicine (Baltimore). 2020 Feb;99(6):e19027
pubmed: 32028413
BJU Int. 2018 Jun;121(6):916-922
pubmed: 29504226
Eur Urol Focus. 2019 Nov;5(6):1135-1142
pubmed: 29934273
Ann Surg Oncol. 2009 Jul;16(7):1799-808
pubmed: 19444524
Eur Urol Focus. 2019 Mar;5(2):290-300
pubmed: 28753890
J Urol. 2012 Feb;187(2):536-41
pubmed: 22177171
J Trauma Acute Care Surg. 2012 Jan;72(1):68-75; discussion 75-7
pubmed: 22310118
J Surg Res. 2018 Feb;222:1-9
pubmed: 29273358
J Surg Res. 2015 Jan;193(1):300-7
pubmed: 25450600
World J Surg. 2012 Sep;36(9):2021-7
pubmed: 22526043
J Urol. 2008 Jun;179(6):2248-52; discussion 2253
pubmed: 18423679
J Urol. 2020 May;203(5):926-932
pubmed: 31846391
J Surg Res. 2020 Nov;255:442-448
pubmed: 32619859
Urology. 2016 Nov;97:98-104
pubmed: 27421783
BJU Int. 2004 May;93(7):937-54
pubmed: 15142141
Adv Surg. 2015;49:235-45
pubmed: 26299502
J Urol. 2014 Aug;192(2):327-35
pubmed: 24857651