A strange study shows that elderly...

A strange study shows that elderly patients undergoing certain major oncology actions have better odds of survival at hospitals that perform relatively high numbers of the operations The study, reported in a Nov 25 1998 abstract in the Journal of the American Medical Association, followed more than 5000 cancer patients 65 years of age and older who underwent pancreatectomy, esophagectomy, pneumonectomy, liver resection, or pelvic exenteration conducts Researchers evaluated each patient's survival 30 days after surgery measuring the impact of age, severity of cancer, and comorbidities upon survival.

Results indicated that for esophagectomy practices the mortality rate after single month in high-volume hospitals was simply 3.4%--compared to 17.3% in low-volume hospitals. Similarly, in pancreatectomy managements the 30-day mortality rate was 129% in low-volume hospitals, plummeting to 58% in high-volume hospitals, according to the thought Adjustments for patient age, cancer state, and comorbidity did not change the finding that cheap volume was strongly associated with exces mortality. Comparable ensues were found for the other processs with the exception of pneumonectomy.

According to a Jan 7 1999 article about the thought in the Medical Tribune, highest-volume hospitals typically perform four to six as many of these high-risk actions as lowest-volume hospitals. The article reports that for these actions physicians should consider referring patients to a specialized center

"Impact of hospital book on operative mortality for major cancer surgery" (Abstract,) Journal of the American Medical Association (Nov 25 1998) A variable from www ama-assn, org/scipubs/journals /archive/jama/vol_280/no_20/oc80665a. htm Accessed 12 Jan 1999; "Cancer surgery survival linked to hospital caseload," Medical Tribune (Jan 7 1999) Available from www.medtrib.com/cgi-bin/medtrib /articles/record?record =40 Accessed 12 Jan 1999

COPYRIGHT 1999 Association of Operating latitude Nurses, Inc.

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