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• W2028103070 abstract "No AccessJournal of UrologyAdult Urology1 Jun 2011Impact of Hospital Volume and Laser Use on Postoperative Complications and In-Hospital Mortality in Cases of Benign Prostate Hyperplasia Toru Sugihara, Hideo Yasunaga, Hiromasa Horiguchi, Hiroaki Nishimatsu, Haruki Kume, Shinya Matsuda, and Yukio Homma Toru SugiharaToru Sugihara School of Public Health, The University of Tokyo, Tokyo, Japan Department of Urology, The University of Tokyo, Tokyo, Japan More articles by this author , Hideo YasunagaHideo Yasunaga Department of Health Management and Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan More articles by this author , Hiromasa HoriguchiHiromasa Horiguchi Department of Health Management and Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan More articles by this author , Hiroaki NishimatsuHiroaki Nishimatsu Department of Urology, The University of Tokyo, Tokyo, Japan More articles by this author , Haruki KumeHaruki Kume Department of Urology, The University of Tokyo, Tokyo, Japan More articles by this author , Shinya MatsudaShinya Matsuda Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Fukuoka, Japan More articles by this author , and Yukio HommaYukio Homma Department of Urology, The University of Tokyo, Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.01.080AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We analyzed the impact of hospital volume and laser use on postoperative complications and in-hospital mortality in transurethral prostatic surgery. Materials and Methods: We evaluated data from 18,578 patients in 686 hospitals who underwent transurethral prostatic surgery between July and December, 2006 to 2008, using the Diagnosis Procedure Combination database in Japan. Cases were divided into low (14 or less per year), medium (14 to 29 per year) or high (30 or more per year) hospital volume groups. Logistic regression analyses were conducted to determine the concurrent effects of hospital volume, laser use and other factors on postoperative complications, transfusion and in-hospital mortality. Laser devices included neodymium:yttrium aluminum garnet and holmium:yttrium aluminum garnet lasers. Results: The overall in-hospital mortality was 0.05% (10 of 18,578 patients) and was not significantly different among groups. The transfusion rates of the low, medium and high volume groups were 8.3%, 7.0% and 5.5%, respectively (low vs high volume adjusted odds ratio 1.55, p <0.01), and postoperative complication rates were 3.7%, 3.2% and 2.6% (low vs high volume OR 1.425, p = 0.016), respectively. An absence of laser use was also a significant risk factor on both measures (OR 1.46 and 2.02, both p <0.01). Teaching hospitals were associated with a higher transfusion rate (OR 1.75), and comorbidities of chronic lung disease, chronic renal failure and malignancy were related to complication rates (OR 1.89, 2.32 and 1.50, respectively). Conclusions: The mortality rate of transurethral prostatic surgery is extremely low and is not affected by hospital volume. However, higher surgical volumes and laser use were significantly associated with lower rates of complications and transfusions. 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Volume 185Issue 6June 2011Page: 2248-2253 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordsmorbidityprostatic hyperplasiamortalitytransurethral resection of prostateprostateAcknowledgmentsHiroaki Miyata from the Department of Healthcare Quality Assessment, Graduate School of Medicine, the University of Tokyo, provided statistical assistance.MetricsAuthor Information Toru Sugihara School of Public Health, The University of Tokyo, Tokyo, Japan Department of Urology, The University of Tokyo, Tokyo, Japan More articles by this author Hideo Yasunaga Department of Health Management and Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan More articles by this author Hiromasa Horiguchi Department of Health Management and Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan More articles by this author Hiroaki Nishimatsu Department of Urology, The University of Tokyo, Tokyo, Japan More articles by this author Haruki Kume Department of Urology, The University of Tokyo, Tokyo, Japan More articles by this author Shinya Matsuda Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Fukuoka, Japan More articles by this author Yukio Homma Department of Urology, The University of Tokyo, Tokyo, Japan More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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