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 20 February 2018

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News

Liver resection mortality in Veteran Affairs vs university centers

The latest Journal of the American College of Surgeons compares liver resection outcomes in Veterans Affairs with those in university medical centers.

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A congressional mandate led to the formation of the National Surgical Quality Improvement Program.

This mandate is now being fulfilled with the publication of general and vascular surgical outcomes comparisons between Veterans Affairs and university medical centers.

A series of National Surgical Quality Improvement Program articles evaluate the effect of hospital type on procedure-specific outcomes.

This article focuses on liver resections.

Unadjusted 30-day mortality rate was 7% in Veterans Affairs hospitals
Journal of the American College of Surgen

Dr Matthew Hutter and colleagues from Massachusetts conducted a prospective cohort study of a sample of patients undergoing liver resections at 128 Veterans Affairs medical centers.

The team compared these with 14 university medical centers from 2001 to 2004.

The team assessed data from 237 liver resections at Veterans Affairs hospitals, and 783 procedures performed at university hospitals.

Preoperative and intraoperative characteristics were evaluated to identify variables related to morbidity and mortality and possible confounders of the hospital effect.

The researchers then used these variables to identify the effect that the hospital setting might have on surgical outcomes after liver resections.

The unadjusted 30-day morbidity rate tended to be higher in the Veterans Affairs.

After risk adjustment, the team observed that the results were equivalent.

The researchers found that the unadjusted 30-day mortality rate was 7% in Veterans Affairs hospitals and 3% in university hospitals.

After risk adjustment, there was no longer a significant difference in mortality between the two hospital systems.

Dr Hutter's team concluded, "For liver resections, the National Surgical Quality Improvement Program and Patient Safety in Surgery Study data suggest that there is no significant difference in risk-adjusted morbidity or mortality rates between Veteran Affairs and the university medical centers."

J Am Coll Surg 2007: 204(6): 1242-51
28 June 2007

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