Het volume van chirurgische ingrepen en de impact ervan op ... - KCE

KCE Reports 113 Volume Outcome 189
The final step in the selection was to discard 962 patients who had undergone two TKR
during two consecutive hospitalizations in the period 2004-2005. This was done to
avoid confusion in identifying and allocating adverse events. The final population
comprised only patients with one TKR in 2004-2005. The volume per hospital was thus
derived from a strict selection of stays, assuming the consecutive steps in the selection
were distributed evenly across all hospitals.
Results of definition: 11 017 stays with one elective total knee replacement
were selected (for 11 017 patients).
7.2.4 Definition of volume
Table 7.23 shows that 114 hospitals performed 97 elective total knee arthroplasty on
average. One hospital performed 557 procedures, the second in volume accounting for
424 procedures. Three quarters of the hospitals performed 120 elective TKR or less.
Table 7.23: Total knee arthroplasty: Summary measures of volume per
hospital
Number Minimum Mean 25th Pctl 50th Pctl 75th Pctl Maximum
114 4.0 96.6 46.0 78.0 120.0 557.0
Figure 7.8: Total knee arthroplasty: volume per hospital
Table 7.24 gives information on the number of elective TKR per surgeon. For surgeons
who work in several hospitals, a sum was made of all their TKR. In 2004, 488
orthopaedic surgeons performed at least one TKR. The mean number of TKR per
surgeon is 23, while the median 12 is. The maximum was 290 elective TKR. Three
quarters of surgeons performed 30 elective TKR or less.
Table 7.24: Total knee arthroplasty: Summary measures of volume per
surgeon
Number Minimum Mean std 25th Pctl 50th Pctl 75th Pctl Maximum
488 1.0 22.6 28.6 5.0 12.0 30.0 290.0