Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 25 May 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Hospital volume influences outcomes of esophageal variceal bleeds in the USA

A study in this month's Clinical Gastroenterology & Hepatology examines the relationship between hospital volume and outcomes of esophageal variceal bleeding in the United States.

News image

fiogf49gjkf04

Esophageal variceal bleeding has a high mortality rate and requires complex management.

High provider volume has been associated with improved outcomes for various surgical procedures and medical diagnoses, and volume-based referral has been advocated.

Dr Robert Myers and colleagues from Canada assessed the volume-outcome relationship in patients with esophageal variceal bleeding.

The research team analyzed the 1998 to 2005 Nationwide Inpatient Sample to identify patients hospitalized for esophageal variceal bleeding.

The effects of hospital volume on in-hospital mortality, length of stay, and hospital charges were evaluated.

The researchers used logistic regression models with adjustment for demographic and clinical factors for the analyses.

Hospital volume was classified on the basis of the average annual number of esophageal variceal bleeding admissions during the study interval.

The research team found that between 1998 and 2005, there were 36,807 hospitalizations in 2575 hospitals for esophageal variceal bleeding.

The researchers noted that 76% of the hospitals were low-volume centers.

Overall, in-hospital mortality was 11%, the median length of stay was 4 days, and total per patient charges were $21,144.

Compared with low-volume centers, admission to a high-volume hospital was associated with an increased risk of death, prolonged stay, and increased total charges.

The team observed that patients admitted to high-volume hospitals were more likely to have negative prognostic characteristics.

The negative prognostic characteristics included male gender, non-white race, nonprivate health insurance, alcoholic cirrhosis, hepatic decompensation, and transferral from another institution.

After adjusting for case mix, the team found that volume was not an independent predictor of in-hospital mortality or length of stay.

However, medium- and high-volume centers had increased total charges.

Dr Myers and team commented, "The volume-outcome relationship observed for some procedures and conditions does not apply to patients with esophageal variceal bleeding."

"Therefore, volume-based referral is not indicated to improve short-term outcomes in this condition."

Clin Gastroenterol Hepatol 2008: 6(7): 789-98
10 July 2008

Go to top of page Email this page Email this page to a colleague

 25 May 2018 
Colorectal cancer–specific mortality
 25 May 2018 
Technology to increase colorectal cancer screening
 25 May 2018 
Post‐operative complications in elderly IBD
 24 May 2018 
Patient-reported outcome measures in IBD trials
 24 May 2018 
Alcohol consumption and outcomes in drug-induced liver injury
 24 May 2018 
Precision medicine for tumors
 23 May 2018 
Management of perianal fistulas in Crohn’s disease
 23 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 23 May 2018 
High body mass index is and ulcerative colitis
 22 May 2018 
Worldwide H.pylori prevalence
 22 May 2018 
PPI and risk of stroke
 22 May 2018 
Online tool predicts bowel dysfunction severity prior to anterior resection
 21 May 2018 
Depressive symptoms in IBD youth
 21 May 2018 
PPI use and cognitive decline
 21 May 2018 
Fecal incontinence and quality of life in IBD
 18 May 2018 
Esophageal dilatation in clinical practice 
 17 May 2018 
IBD and later extraintestinal manifestations
 17 May 2018 
Repeat stool DNA testing
 17 May 2018 
IBS and chronic fatigue following GI infection
 16 May 2018 
Factors associated with fecal incontinence
 16 May 2018 
Diagnostic delay in Crohn's disease
 16 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 15 May 2018 
Guidelines for management of Crohn's
 15 May 2018 
Hep B in the Grey Zone
 15 May 2018 
New therapies for CDI
 14 May 2018 
Blood test for the diagnosis of fibrotic NASH
 14 May 2018 
Outcomes at bariatric centers of excellence
 14 May 2018 
Management of perianal fistulas in Crohn’s
 11 May 2018 
Detection of undiagnosed celiac disease
 11 May 2018 
Alcohol consumption and drug-induced liver injury
 10 May 2018 
Colorectal cancer screening
 10 May 2018 
Fibrosis in patients with chronic hepatitis B
 09 May 2018 
Fecal incontinence
 09 May 2018 
Health problems and IBS
 09 May 2018 
Esophageal dilatation in clinical practice 
 07 May 2018 
Omitting antibiotics in uncomplicated acute diverticulitis
 07 May 2018 
Health problems and IBS
 07 May 2018 
Assessment of diminutive colorectal polyps
 04 May 2018 
National Institutes of Health workshop and obesity
 04 May 2018 
Factors associated with fecal incontinence
 04 May 2018 
Colorectal cancer screening and ethnic inequities
 03 May 2018 
Gastrointestinal ultrasound in IBD
 03 May 2018 
Ultransonography in postsurgical recurrence in Crohn's
 02 May 2018 
Symptom assessment in cirrhotic ascites
 02 May 2018 
Hep C antiviral treatment and liver cancer risk
 02 May 2018 
Chronic Hep B
 01 May 2018 
European guidelines on pancreatic cystic neoplasms
 01 May 2018 
Interferon‐free regimens in Hep C
 01 May 2018 
Age at IBD onset and extraintestinal complications
 30 April 2018 
Formula for preterm infants
 30 April 2018 
Primary antibiotic resistance and sequential therapy for H. pylori
 27 April 2018 
Eastern and western practices for endoscopic resection of colorectal lesions
 27 April 2018 
Anxiety scale for chronic esophageal disease
 27 April 2018 
Disease activity in eosinophilic esophagitis
 26 April 2018 
Obesity and physical activity in diverticulosis
 26 April 2018 
Primary sclerosing cholangitis in the USA
 25 April 2018 
Aspirin and pancreatic cancer
 25 April 2018 
Central mediators of irinotecan-induced steatohepatitis
 25 April 2018 
Neuroimaging in Hep C
 24 April 2018 
Scoring system identifies cancer risk in Barrett's

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us