Table 2.
Indirect evidence from the volume-outcome relationship from adult colorectal surgery
| Archampong et al. [26] (unadjusted) | IQWiG report [27] | |||
|---|---|---|---|---|
| Surgeon VO (yes/no) | Hospital VO (yes/no) | Surgeon VO (yes/no) | Hospital VO (yes/no) | |
| Faecal incontinence | – | – | – | – |
| Permanent stoma rate as indirect parameter for anastomotic problems |
Yes: 0.75 [0.62, 0.89]* |
Yes: 0.86 [0.75, 1.00]* |
Yes: 1 out of 1 study |
Yes: 2 out of 3 studies** |
| Constipation/obstructive defecation | – | – | – | – |
| Anastomotic stricture | – | – | – | – |
| Anastomotic leak |
Yes: 0.67 [0.49, 0.92]* |
No: 1.18 [0.87, 1.58]* |
– | – |
| Length of primary hospital stay | – | – |
Yes: 1 out of 1 study |
Yes: 1 out of 3 studies** |
| Early Mortality (within hospital stay or 30-days postoperatively) |
Yes: 0.65 [0.57, 0.75]* |
Yes: 0.75 [0.68, 0.84]* |
Yes: 1 out of 1 study |
yes: 5 out of 9 studies** |
| Reoperation Rate | – | – |
No: 1 out of 1 study** |
No: 1 out of 1 study** |
| Wound infection | – | – | – |
no: 1 out of 1 study |
| Readmission Rate | – | – |
No: 1 out of 1 study** |
No: 2 out of 2 studies** |
– Not evaluated
VO volume-outcome
*odds ratio with CI 95% in favour of the respective high-volume category, **those study that did not reveal significant results with better outcomes in high-volume hospitals also did not reveal significant results with better outcomes in low-volume hospitals