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High Anesthesiologist Volume Tied to Better Outcomes for Complex GI Surgical Cases

WEDNESDAY, March 24, 2021 -- Adults undergoing complex gastrointestinal (GI) cancer surgery have a lower risk for adverse postoperative outcomes when receiving care from high-volume anesthesiologists, according to a study published online March 17 in JAMA Surgery.

Julie Hallet, M.D., from the University of Toronto, and colleagues used administrative health care data sets to examine the association between anesthesiologist volume and short-term postoperative outcomes for complex surgery (esophagectomy, pancreatectomy, and hepatectomy) for GI cancer (8,096 patients).

The researchers found that operations were supported by 842 anesthesiologists (median annual volume of three procedures per year) and performed by 186 surgeons. Just over one-quarter of patients (26.7 percent) received care from high-volume anesthesiologists. The primary outcome (a composite of 90-day major morbidity and readmission) occurred in 36.3 percent of patients in the high-volume group and 45.7 percent of patients in the low-volume group. There was an independent association between care by high-volume anesthesiologists and lower odds of the primary outcome (adjusted odds ratio [aOR], 0.85; 95 percent confidence interval [CI], 0.76 to 0.94), major morbidity (aOR, 0.83; 95 percent CI, 0.75 to 0.91), and unplanned intensive care unit admission (aOR, 0.84; 95 percent CI, 0.76 to 0.94). However, there were no associations noted between volume and readmission (aOR, 0.87; 95 percent CI, 0.73 to 1.05) or mortality (aOR, 1.05; 95 percent CI, 0.84 to 1.31).

"These findings support organizing perioperative care to increase anesthesiologist volume to optimize patient outcomes," the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

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