Impact of hospital and surgeon volumes in the management of complicated portal hypertension: Review of a statewide database in Florida

Emmanuel E. Zervos, Dana Osborne, Steven Agle, Micheal M. McNally, Brian Boe, Alexander S. Rosemurgy

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Mortality after complex surgical procedures has been shown to be inversely related to hospital volume. The purpose of this study was to determine whether these findings are applicable to radiologic and surgical procedures for complicated portal hypertension. The Agency for Healthcare Administration for the State of Florida database was queried to determine outcomes after transjugular intrahepatic stent shunts (TIPS) or surgical shunts from 2000 to 2003. A total of 1486 patients underwent either TIPS (1321) or surgical shunts (165). Natural breakpoints occurred at two and six procedures per year were correlated with survival for surgical shunts but not TIPS. Overall mortality was not different between TIPS and surgical shunts (11.0 vs. 12.7%, P = 0.51); however, the cost of TIPS was significantly lower (62,000 ± 58.5 vs. 107,000 ± 97.8, P <0.001) as well as the length of hospitalization (9 ± 9.0 days vs. 15 days ± 12.6 days, P <0.001). Surgical procedures for complicated portal hypertension are rapidly being replaced by TIPS. Like with other complex procedures, outcomes are related to hospital volume.

Original languageEnglish (US)
Pages (from-to)263-269
Number of pages7
JournalThe American surgeon
Volume76
Issue number3
StatePublished - Mar 2010
Externally publishedYes

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Portal Hypertension
Stents
Databases
Mortality
Surgeons
Hospitalization
Delivery of Health Care
Costs and Cost Analysis
Survival

ASJC Scopus subject areas

  • Surgery

Cite this

Zervos, E. E., Osborne, D., Agle, S., McNally, M. M., Boe, B., & Rosemurgy, A. S. (2010). Impact of hospital and surgeon volumes in the management of complicated portal hypertension: Review of a statewide database in Florida. The American surgeon, 76(3), 263-269.

Impact of hospital and surgeon volumes in the management of complicated portal hypertension : Review of a statewide database in Florida. / Zervos, Emmanuel E.; Osborne, Dana; Agle, Steven; McNally, Micheal M.; Boe, Brian; Rosemurgy, Alexander S.

In: The American surgeon, Vol. 76, No. 3, 03.2010, p. 263-269.

Research output: Contribution to journalArticle

Zervos, EE, Osborne, D, Agle, S, McNally, MM, Boe, B & Rosemurgy, AS 2010, 'Impact of hospital and surgeon volumes in the management of complicated portal hypertension: Review of a statewide database in Florida', The American surgeon, vol. 76, no. 3, pp. 263-269.
Zervos, Emmanuel E. ; Osborne, Dana ; Agle, Steven ; McNally, Micheal M. ; Boe, Brian ; Rosemurgy, Alexander S. / Impact of hospital and surgeon volumes in the management of complicated portal hypertension : Review of a statewide database in Florida. In: The American surgeon. 2010 ; Vol. 76, No. 3. pp. 263-269.
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