Behind the Curtain—Implications of Anesthesia Volume on Outcomes
Menée à partir de données portant sur 8 096 patients atteints d'un cancer gastrointestinal traité entre 2007 et 2018 par oesophagectomie, pancréatectomie ou hépatectomie (âge médian : 65 ans ; 66,3 % d'hommes), cette étude évalue l'association entre le nombre annuel d'interventions réalisées par l'anesthésiste en oncochirurgie digestive et le risque d'événements indésirables postopératoires
The association between volume and outcome has been studied for decades. Countless studies have demonstrated better postoperative outcomes with higher volume, but the presence and magnitude of this association vary widely across procedures and patients, indicating that it is not a generalizable concept. In evaluating this association, much of the focus has been on the individual surgeon and the hospital. However, less is known about the contribution of the other members of the surgical team.In this issue of JAMA Surgery, Hallet et al sought to ascertain whether an association exists between anesthesiologist volume and adverse perioperative outcomes at regionalized centers in Ontario, Canada. Using retrospective data from a population-based registry, the authors found that care by a high-volume anesthesiologist was independently associated with a lower risk of 90-day major morbidity and unplanned intensive care unit admission in patients who underwent hepatectomy, pancreatectomy, and esophagectomy for gastrointestinal cancer.
JAMA Surgery , éditorial, 2020