Association of Surgeon Volume With Outcomes and Cost Savings Following Thyroidectomy

Al‐Qurayshi, Zaid; Robins, Russell P.; Hauch, Adam; Randolph, Gregory W.; Kandil, Emad

doi:10.1001/jamaoto.2015.2503

Cited by 172 publications

(170 citation statements)

References 32 publications

(29 reference statements)

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“…The outcomes of interest included 1) postoperative complications: complications were classified based on ICD‐9 codes that were adopted from a previously published study, 2) in‐hospital mortality either during admission or during readmission within 30 days postoperatively, 3) readmission risk within 30 days postoperatively, 4) hospital length of stay (LOS) in days and the total LOS of the first admission and readmission if one occurred, and 5) cost of health services. The database includes hospital charges associated with each admission as well as the cost‐to‐charge ratio determined for each hospital that allows conversion of charges values to cost values.…”

Section: Methodsmentioning

confidence: 99%

Outcomes of head and neck surgery in patients with a history of solid organ transplantation

et al. 2019

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Objectives/Hypothesis Examine the prevalence and outcomes of head and neck surgeries in patients with a history of organ transplantation. Study Design A retrospective cross‐sectional analysis utilizing the Nationwide Readmissions Database, 2010 to 2014. Methods The study population included adults patients who underwent head and neck surgeries. Patients with a reported history of solid organ transplantation were compared to patients with no such history. Results The study population included 322 transplant patients (76.4% kidney, 8.7% liver, 8.4% heart, 3.0% kidney/pancreas, 2.3% lung, 0.9% kidney/liver, 0.4% pancreas) and 120,401 controls who underwent comparable procedures. Main surgeries that were performed in cases included 37.8% parathyroid, 17.7% thyroid, 11.2% major salivary gland, 10.6% major mouth/tonsil, and 9.6% major nose/paranasal sinuses. Encountering transplant patients in otolaryngology practice has been increasing annually by three patients for every 10,000 procedures performed in the United States. There was no difference in the overall postoperative complications risk (12.5% vs. 10.1%, P = .26); however, cases had a higher risk of acute renal failure (5.4% vs. 1.1%, P < .001) and shock state (0.3% vs. 0.02%, P < .001). Readmission risk was higher for cases (6.8% vs. 3.4%, P = .003). There was no reported in‐hospital mortality among cases. Conclusions Transplant patients are increasingly encountered in otolaryngology practices. The most common transplanted organ is kidney, and the most commonly performed procedure is parathyroidectomy. Level of Evidence NA Laryngoscope, 130:E89–E97, 2020

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Section: Methodsmentioning

confidence: 99%

Outcomes of head and neck surgery in patients with a history of solid organ transplantation

et al. 2019

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“…Surgeon‐related factors (annual operation volume, years of experience) also play an important role in short‐term clinical outcomes of PTC. In recent decades, numerous studies have demonstrated that patients receiving care from high‐volume surgeons have fewer surgical complications (especially recurrent laryngeal nerve injury and hypocalcaemia), shorter length of hospital stay, fewer hospital deaths and lower costs. It has also been suggested that surgeon experience, represented by age or years of experience, is related to complication rate.…”

Section: Introductionmentioning

confidence: 99%

Surgeon volume and prognosis of patients with advanced papillary thyroid cancer and lateral nodal metastasis

Kim

Choe

et al. 2018

British Journal of Surgery

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“…In addition to RLN and parathyroid postoperative assessment, other more global measures of perioperative quality of care should be assessed. Multiple studies examining quality and safety in thyroid surgery assess mortality, readmissions with and without related data on reoperations, and LOS . Recommended quality metrics include mortality rates, readmission rates, reoperation rates, and LOS in hospital.…”

Section: Resultsmentioning

confidence: 99%

American Head and Neck Society Endocrine Section clinical consensus statement: North American quality statements and evidence‐based multidisciplinary workflow algorithms for the evaluation and management of thyroid nodules

et al. 2018

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Background Care for patients with thyroid nodules is complex and multidisciplinary, and research demonstrates variation in care. The objective was to develop clinical guidelines and quality metrics to reduce unwarranted variation and improve quality. Methods Multidisciplinary expert consensus and modified Delphi approach. Source documents were workflow algorithms from Kaiser Permanente Northern California and Cancer Care of Ontario based on the 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. Results A consensus‐based, unified preoperative, perioperative, and postoperative workflow was developed for North American use. Twenty‐one panelists achieved consensus on 16 statements about workflow‐embedded process and outcomes metrics addressing safety, access, appropriateness, efficiency, effectiveness, and patient centeredness of care. Conclusion A panel of Canadian and United States experts achieved consensus on workflows and quality metric statements to help reduce unwarranted variation in care, improving overall quality of care for patients diagnosed with thyroid nodules.

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Association of Surgeon Volume With Outcomes and Cost Savings Following Thyroidectomy

Abstract: A surgeon's expertise (measured by surgical volume of procedures per year) is associated with favorable clinical as well as financial outcomes. Our model estimates that considerable cost savings are attainable if higher-volume surgeons perform thyroid procedures in the United States.

Cited by 172 publications

References 32 publications

Outcomes of head and neck surgery in patients with a history of solid organ transplantation

Outcomes of head and neck surgery in patients with a history of solid organ transplantation

Surgeon volume and prognosis of patients with advanced papillary thyroid cancer and lateral nodal metastasis

American Head and Neck Society Endocrine Section clinical consensus statement: North American quality statements and evidence‐based multidisciplinary workflow algorithms for the evaluation and management of thyroid nodules

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