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

More documents

Recommendations

Info

70 Volume Outcome KCE reports 113 5.3.4 Definition of volume As shown in Table 5.24, the 311 procedures (selected in the MCD) were performed in 74 centres by 112 surgeons. Three quarters of the hospitals performed 4 procedures or less. Table 5.24: Pancreatic cancer surgery: Summary measures of volume per hospital and per surgeon 25th 50th 75th Number mean minimum Pctl Pctl Pctl maximum Hospitals 74 4.2 1.0 1.0 2.0 4.0 50.0 Surgeons* 112 2.7 1.0 1.0 1.0 2.0 25.0 * For 14 procedures information on surgeon was missing. Figure 5.9: Pancreatic cancer surgery: Volume per hospital X means stage not known. Figure 5.10: Pancreatic cancer surgery: Volume per surgeon X means stage not known.
KCE Reports 113 Volume Outcome 71 5.3.5 Definition of outcomes 5.3.5.1 Mortality Table 5.25 shows that in-hospital and approximate 30-day mortality is 8.3% after pancreatic cancer surgery (25 deaths). Survival 1 year after surgery is 68.1%. After 2 years, survival is only 46.8%. Median survival time was 23 months (not visible in Table 5.25). Table 5.25 illustrates well how 2-year survival after pancreatectomy is affected by the principle diagnosis. Patients who are diagnosed with a malignant neoplasm of extrahepatic bile ducts or ampulla of Vater have a far better survival rate (66.7%) than those with a malignant neoplasm of duodenum (36.8%) or pancreas (43.3%). These differences confirm the necessity to add the principal diagnosis to the risk adjustment. Table 5.25: Pancreatic cancer surgery: Mortality results Number Number % Survival deaths deaths In-hospital and approximate 30-day mortality 301 25 8.3 3 months mortality 301 34 11.3 1-year mortality 301 96 31.9 68.1 2-year mortality 2-year mortality in function of principal diagnosis: 301 160 53.2 46.8 152 Malignant neoplasm of small intestine, including duodenum 19 12 63.2 36.8 1561 Malignant neoplasm of extrahepatic bile ducts or 1562 Malignant neoplasm of ampulla of Vater 51 17 33.3 66.7 157 Malignant neoplasm of pancreas 231 131 56.7 43.3 Figure 5.11 illustrates how survival improves with decreasing disease stage. Patients with unknown disease stage (purple line) are in between those with stage 1 and stage 2 disease and have a rather good survival rate. Figure 5.11: Pancreatic cancer surgery: Survival curve by stage X means stage not known.
Page 1 and 2:
Het volume van chirurgische ingrepe
Page 3 and 4:
Het volume van chirurgische ingrepe
Page 5 and 6:
KCE reports 113A Volume - Uitkomst
Page 7 and 8:
Page 9 and 10:
Page 11 and 12:
Page 13 and 14:
Page 15 and 16:
Page 17 and 18:
KCE Reports 113 Volume Outcome 1 Sc
Page 19 and 20:
KCE Reports 113 Volume Outcome 3 6.
Page 21 and 22:
KCE Reports 113 Volume Outcome 5 Ab
Page 23 and 24:
KCE Reports 113 Volume Outcome 7 2
Page 25 and 26:
KCE Reports 113 Volume Outcome 9 5.
Page 27 and 28:
KCE Reports 113 Volume Outcome 11 O
Page 29 and 30:
KCE Reports 113 Volume Outcome 13 F
Page 31 and 32:
KCE Reports 113 Volume Outcome 15 T
Page 33 and 34:
KCE Reports 113 Volume Outcome 17 P
Page 35 and 36: KCE Reports 113 Volume Outcome 19 T
Page 37 and 38: KCE Reports 113 Volume Outcome 21 3
Page 43 and 44: KCE Reports 113 Volume Outcome 27 F
Page 49 and 50: KCE Reports 113 Volume Outcome 33 H
Page 73 and 74: KCE Reports 113 Volume Outcome 57 R
Page 77 and 78: KCE Reports 113 Volume Outcome 61 C
Page 79 and 80: KCE Reports 113 Volume Outcome 63 A
Page 85: KCE Reports 113 Volume Outcome 69 5
Page 93 and 94: KCE Reports 113 Volume Outcome 77 D
Page 109 and 110: KCE Reports 113 Volume Outcome 93 R
Page 113 and 114: KCE Reports 113 Volume Outcome 97 V
Page 117 and 118: KCE Reports 113 Volume Outcome 101
Page 137 and 138:
KCE Reports 113 Volume Outcome 121
Page 139 and 140:
Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
Page 151 and 152:
Page 153 and 154:
Page 155 and 156:
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164:
Page 165 and 166:
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
Page 173 and 174:
Page 175 and 176:
Page 177 and 178:
Page 179 and 180:
Page 181 and 182:
Page 183 and 184:
Page 185 and 186:
Page 187 and 188:
Page 189 and 190:
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Page 199 and 200:
Page 201 and 202:
Page 203 and 204:
Page 205 and 206:
Page 207 and 208:
Page 209 and 210:
Page 211 and 212:
Page 213 and 214:
Page 215 and 216:
Page 217 and 218:
Page 219 and 220:
Page 221 and 222:
Page 223 and 224:
Page 225 and 226:
Page 227 and 228:
Page 229 and 230:
Page 231 and 232:
Page 233 and 234:
Page 235 and 236:
Page 237 and 238:
Page 239 and 240:
Page 241 and 242:
Page 243 and 244:
Page 245 and 246:
Page 247 and 248:
Page 249 and 250:
Page 251 and 252:
Page 253 and 254:
This page is left intentionally bla
Page 255 and 256:
KCE reports 1. Effectiviteit en kos
Page 257 and 258:
73. Financiering van het zorgprogra
show all

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

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?