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dc.contributor.authorMarkar, Sheraz
dc.contributor.authorSantoni, Giola
dc.contributor.authorMaret-Ouda, John
dc.contributor.authorArtama, Miia
dc.contributor.authorFärkkilä, Martti
dc.contributor.authorLynge, Elsebeth
dc.contributor.authorPukkala, Eero
dc.contributor.authorNess-Jensen, Eivind
dc.contributor.authorvon Euler-Chelpin, My
dc.contributor.authorLagergren, Jesper
dc.date.accessioned2020-02-13T12:20:09Z
dc.date.available2020-02-13T12:20:09Z
dc.date.created2020-01-20T22:15:59Z
dc.date.issued2020
dc.identifier.issn0003-4932
dc.identifier.urihttp://hdl.handle.net/11250/2641555
dc.description.abstractObjective: To test the hypothesis that higher hospital volume decreases endoscopic and surgical re-intervention rates after antireflux surgery. Background: Antireflux surgery for gastro-esophageal reflux disease is followed by varying rates of re-interventions. Whether hospital volume influences re-intervention rates is uncertain. Methods: This population-based cohort study used nationwide data from Denmark, Finland, and Sweden for patients having undergone primary antireflux surgery. Hospitals were divided into tertiles based upon annual volume, that is, 3 equal-sized groups. The outcomes were 30-day surgical re-intervention, endoscopic re-intervention, and secondary antireflux surgery. Multivariable Cox regression provided hazard ratios (HRs) with 95% confidence intervals (CIs) for risk of the first outcome occurrence. Incidence rate ratios were calculated to count all outcome occurrences. All risk estimates were adjusted for age, sex, comorbidity, type of antireflux surgery, year of surgery, and country. Results: Among 33,060 patients and a median follow-up of 12 years after antireflux surgery, the frequencies of 30-day re-intervention, endoscopic re-intervention, and secondary antireflux surgery were 1.2%, 4.6%, and 7.0%, respectively. When comparing the highest with the lowest tertiles, higher hospital volume did not decrease HRs of 30-day re-intervention (adjusted HR = 1.14, 95% CI 0.73–1.77), endoscopic re-intervention (HR = 1.21, 95% CI 0.96–1.51), or secondary antireflux surgery (HR = 1.28, 95% CI 1.05–1.54), but rather increased point estimates. The incidence rate ratios showed similar patterns. Conclusions: Higher hospital volume of primary antireflux surgery may not decrease risk of endoscopic or surgical re-intervention, suggesting that centralization will not decrease rates of postoperative complications or recurrence of gastro-esophageal reflux disease.nb_NO
dc.language.isoengnb_NO
dc.publisherLippincott, Williams & Wilkinsnb_NO
dc.titleHospital Volume of Antireflux Surgery in Relation to Endoscopic and Surgical Re-interventionsnb_NO
dc.typeJournal articlenb_NO
dc.typePeer reviewednb_NO
dc.description.versionacceptedVersionnb_NO
dc.source.journalAnnals of Surgerynb_NO
dc.identifier.doi10.1097/SLA.0000000000003776
dc.identifier.cristin1778652
dc.description.localcode© 2020. This is the authors' accepted and refereed manuscript to the chapter. Locked until 6.1.2021 due to copyright restrictions. The final authenticated version is available online at: http://dx.doi.org/10.1097/SLA.0000000000003776nb_NO
cristin.unitcode194,65,20,15
cristin.unitnameHelseundersøkelsen i Nord-Trøndelag
cristin.ispublishedtrue
cristin.fulltextpostprint
cristin.qualitycode2


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