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  • Springer Science and Business Media LLC  (5)
  • Elfrink, Arthur K. E.  (5)
  • 1
    Online Resource
    Online Resource
    Practice variation and outcomes of minimally invasive minor liver resections in patients with colorectal liver metastases: a population-based study
    Springer Science and Business Media LLC ; 2023
    In:  Surgical Endoscopy Vol. 37, No. 8 ( 2023-08), p. 5916-5930
    Details
    In: Surgical Endoscopy, Springer Science and Business Media LLC, Vol. 37, No. 8 ( 2023-08), p. 5916-5930
    Abstract: In 2017, the Southampton guideline stated that minimally invasive liver resections (MILR) should considered standard practice for minor liver resections. This study aimed to assess recent implementation rates of minor MILR, factors associated with performing MILR, hospital variation, and outcomes in patients with colorectal liver metastases (CRLM). Methods This population-based study included all patients who underwent minor liver resection for CRLM in the Netherlands between 2014 and 2021. Factors associated with MILR and nationwide hospital variation were assessed using multilevel multivariable logistic regression. Propensity-score matching (PSM) was applied to compare outcomes between minor MILR and minor open liver resections. Overall survival (OS) was assessed with Kaplan–Meier analysis on patients operated until 2018. Results Of 4,488 patients included, 1,695 (37.8%) underwent MILR. PSM resulted in 1,338 patients in each group. Implementation of MILR increased to 51.2% in 2021. Factors associated with not performing MILR included treatment with preoperative chemotherapy (aOR 0.61 CI:0.50–0.75, p   〈  0.001), treatment in a tertiary referral hospital (aOR 0.57 CI:0.50–0.67, p   〈  0.001), and larger diameter and number of CRLM. Significant hospital variation was observed in use of MILR (7.5% to 93.0%). After case-mix correction, six hospitals performed fewer, and six hospitals performed more MILRs than expected. In the PSM cohort, MILR was associated with a decrease in blood loss (aOR 0.99 CI:0.99–0.99, p   〈  0.01), cardiac complications (aOR 0.29, CI:0.10–0.70, p  = 0.009), IC admissions (aOR 0.66, CI:0.50–0.89, p  = 0.005), and shorter hospital stay (aOR CI:0.94–0.99, p   〈  0.01). Five-year OS rates for MILR and OLR were 53.7% versus 48.6%, p  = 0.21. Conclusion Although uptake of MILR is increasing in the Netherlands, significant hospital variation remains. MILR benefits short-term outcomes, while overall survival is comparable to open liver surgery. Graphical abstract
    Type of Medium: Online Resource
    ISSN: 0930-2794 , 1432-2218
    URL: Article
    DOI: 10.1007/s00464-023-10010-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1463171-4
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  • 2
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    Online Resource
    Correction to: Development of a data-driven case-mix adjustment model for comparison of hospital performance in hip fracture care
    Springer Science and Business Media LLC ; 2022
    In:  Archives of Osteoporosis Vol. 17, No. 1 ( 2022-12)
    Details
    In: Archives of Osteoporosis, Springer Science and Business Media LLC, Vol. 17, No. 1 ( 2022-12)
    Type of Medium: Online Resource
    ISSN: 1862-3522 , 1862-3514
    URL: Article
    DOI: 10.1007/s11657-022-01121-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2253231-6
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  • 3
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    Development of a data-driven case-mix adjustment model for comparison of hospital performance in hip fracture care
    Springer Science and Business Media LLC ; 2022
    In:  Archives of Osteoporosis Vol. 17, No. 1 ( 2022-12)
    Details
    In: Archives of Osteoporosis, Springer Science and Business Media LLC, Vol. 17, No. 1 ( 2022-12)
    Abstract: To compare hospitals’ hip fracture patient mortality in a quality of care registry, correction for patient characteristics is needed. This study evaluates in 39,374 patients which characteristics are associated with 30 and 90-day mortality, and showed how using these characteristics in a case mix-model changes hospital comparisons within the Netherlands. Purpose Mortality rates after hip fracture surgery are considerable and may be influenced by patient characteristics. This study aims to evaluate hospital variation regarding patient demographics and disease burden, to develop a case-mix adjustment model to analyse differences in hip fracture patients’ mortality to calculate case-mix adjusted hospital-specific mortality rates. Methods Data were derived from 64 hospitals participating in the Dutch Hip Fracture Audit (DHFA). Adult hip fracture patients registered in 2017–2019 were included. Variation of case-mix factors between hospitals was analysed, and the association between case-mix factors and mortality at 30 and 90 days was determined through regression models. Results There were 39,374 patients included. Significant variation in case-mix factors amongst hospitals was found for age ≥ 80 (range 25.8–72.1% p   〈  0.001), male gender (12.0–52.9% p   〈  0.001), nursing home residents (42.0–57.9% p   〈  0.001), pre-fracture mobility aid use (9.9–86.7% p   〈  0,001), daily living dependency (27.5–96.5% p   〈  0,001), ASA-class ≥ 3 (25.8–83.3% p   〈  0.001), dementia (3.6–28.6% p   〈  0.001), osteoporosis (0.0–57.1% p   〈  0.001), risk of malnutrition (0.0–29.2% p   〈  0.001) and fracture types (all p   〈  0.001). All factors were associated with 30- and 90-day mortality. Eight hospitals showed higher and six showed lower 30-day mortality than expected based on their case-mix. Six hospitals showed higher and seven lower 90-day mortality than expected. The specific outlier hospitals changed when correcting for case-mix factors. Conclusions Dutch hospitals show significant case-mix variation regarding hip fracture patients. Case-mix adjustment is a prerequisite when comparing hospitals’ 30-day and 90-day hip fracture patients’ mortality. Adjusted mortality may serve as a starting point for improving hip fracture care.
    Type of Medium: Online Resource
    ISSN: 1862-3522 , 1862-3514
    URL: Article
    DOI: 10.1007/s11657-022-01094-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2253231-6
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  • 4
    Online Resource
    Online Resource
    Outcomes After Major Surgical Procedures in Octogenarians: A Nationwide Cohort Study
    Springer Science and Business Media LLC ; 2022
    In:  World Journal of Surgery Vol. 46, No. 10 ( 2022-10), p. 2399-2408
    Details
    In: World Journal of Surgery, Springer Science and Business Media LLC, Vol. 46, No. 10 ( 2022-10), p. 2399-2408
    Abstract: Aging of the worldwide population has been observed, and postoperative outcomes could be worse in elderly patients. This nationwide study assessed trends in number of surgical resections in octogenarians regarding various major surgical procedures and associated postoperative outcomes. Methods All patients who underwent surgery between 2014 and 2018 were included from Dutch nationwide quality registries regarding esophageal, stomach, pancreas, colorectal liver metastases, colorectal cancer, lung cancer and abdominal aortic aneurysms (AAA). For each quality registry, the number of patients who were 80 years or older (octogenarians) was calculated per year. Postoperative outcomes were length of stay (LOS), 30 day major morbidity and 30 day mortality between octogenarians and younger patients. Results No increase in absolute number and proportion of octogenarians that underwent surgery was observed. Median LOS was higher in octogenarians who underwent surgery for colorectal cancer, colorectal liver metastases, lung cancer, pancreatic disease and esophageal cancer. 30 day major morbidity was higher in octogenarians who underwent surgery for colon cancer, esophageal cancer and elective AAA-repair. 30 day mortality was higher in octogenarians who underwent surgery for colorectal cancer, lung cancer, stomach cancer, pancreatic disease, esophageal cancer and elective AAA-repair. Median LOS decreased between 2014 and 2018 in octogenarians who underwent surgery for stomach cancer and colorectal cancer. 30 day major morbidity decreased between 2014 and 2018 in octogenarians who underwent surgery for colon cancer. No trends were observed in octogenarians regarding 30 day mortality between 2014 and 2018. Conclusion No increase over time in absolute number and proportion of octogenarians that underwent major surgery was observed in the Netherlands. Postoperative outcomes were worse in octogenarians.
    Type of Medium: Online Resource
    ISSN: 0364-2313 , 1432-2323
    URL: Article
    DOI: 10.1007/s00268-022-06642-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1463296-2
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  • 5
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    Online Resource
    Minimally Invasive Oncologic Upper Gastrointestinal Surgery can be Performed Safely on all Weekdays: A Nationwide Cohort Study
    Springer Science and Business Media LLC ; 2021
    In:  World Journal of Surgery Vol. 45, No. 9 ( 2021-09), p. 2816-2829
    Details
    In: World Journal of Surgery, Springer Science and Business Media LLC, Vol. 45, No. 9 ( 2021-09), p. 2816-2829
    Abstract: Existing literature suggests deteriorating surgical outcome of esophagogastric surgery as the week progresses. However, these studies were conducted in the pre-centralization and pre-minimally invasive era. In addition, they failed to correct for fixed weekdays of esophagogastric cancer surgery among hospitals. This study aimed to describe the impact of weekday of minimally invasive upper gastrointestinal surgery on short-term surgical outcomes. Methods All patients registered in the Dutch Upper Gastrointestinal Cancer Audit who underwent curative minimally invasive esophageal or gastric carcinoma surgery in 2015–2019, were included in this nationwide cohort study. Using multilevel multivariable logistic regression, the impact of weekday of surgery on 14 short-term surgical outcomes was investigated. To correct for interhospital variance in fixed weekday(s) of surgery multilevel analyses was used. Results were adjusted for patient, tumor, and treatment characteristics using multivariable logistic regression analyses. Results This study included 4,102 patients undergoing minimally invasive upper gastrointestinal surgery (2,968 esophageal cancer and 1,134 gastric cancer patients). Weekday of surgery did not impact postoperative complications, severe postoperative complications, surgical/technical complications, medical complications, anastomotic leakage, complicated postoperative course, failure to rescue, surgical radicality, lymph node yield, 30-day/in-hospital mortality, reinterventions, length of ICU stay, 30-day readmission, and textbook outcome after neither esophageal cancer nor gastric cancer surgery. Conclusions Minimally invasive esophagogastric surgery can be performed safely on all weekdays with respect to short-term surgical outcomes, which is important information for operation room scheduling.
    Type of Medium: Online Resource
    ISSN: 0364-2313 , 1432-2323
    URL: Article
    DOI: 10.1007/s00268-021-06160-x
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 1463296-2
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