Table 2.
ORs of inhospital death according to volume quintile
| Hospital volume quintile | ||||||||||
| Very low | Low | Medium | High | Very high | ||||||
| Common emergency conditions | ||||||||||
| Acute myocardial infarction | Crude OR | 1.00 | 0.82 | 0.74 | 0.72 | 0.71 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.84* | (0.81 to 0.87) | 0.75* | (0.72 to 0.78) | 0.73* | (0.7 to 0.76) | 0.69* | (0.66 to 0.72) | |
| Heart failure | Crude OR | 1.00 | 0.95 | 0.89 | 0.87 | 0.81 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.99 | (0.96 to 1.01) | 0.96* | (0.93 to 0.99) | 0.95* | (0.92 to 0.98) | 0.91* | (0.88 to 0.94) | |
| Ischaemic stroke | Crude OR | 1.00 | 0.77 | 0.70 | 0.70 | 0.72 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.90* | (0.87 to 0.94) | 0.87* | (0.83 to 0.9) | 0.94* | (0.91 to 0.98) | 0.94* | (0.91 to 0.98) | |
| Pneumonia | Crude OR | 1.00 | 1.09 | 1.16 | 1.12 | 1.08 | ||||
| Adjusted OR (95% CI) | 1.00 | 1.10 | (1.07 to 1.13) | 1.17 | (1.14 to 1.21) | 1.13 | (1.09 to 1.16) | 1.08 | (1.04 to 1.11) | |
| Chronic obstructive pulmonary disease | Crude OR | 1.00 | 1.06 | 1.04 | 0.91 | 0.66 | ||||
| Adjusted OR (95% CI) | 1.00 | 1.09 | (1.06 to 1.14) | 1.08 | (1.04 to 1.12) | 0.94* | (0.90 to 0.98) | 0.70* | (0.65 to 0.75) | |
| Hip fracture | Crude OR | 1.00 | 1.06 | 1.06 | 1.07 | 1.00 | ||||
| Adjusted OR (95% CI) | 1.00 | 1.07 | (1.03 to 1.12) | 1.07 | (1.03 to 1.11) | 1.10 | (1.06 to 1.15) | 1.01 | (0.97 to 1.06) | |
| Elective heart and thoracic surgery | ||||||||||
| Isolated surgical aortic valve replacement | Crude OR | 1.00 | 0.90 | 0.80 | 0.74 | 0.74 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.87 | (0.69 to 1.10) | 0.78* | (0.62 to 0.99) | 0.69* | (0.54 to 0.87) | 0.77* | (0.61 to 0.97) | |
| Transcatheter aortic valve replacement | Crude OR | 1.00 | 0.97 | 0.90 | 0.78 | 0.64 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.98 | (0.69 to 1.1) | 0.87* | (0.62 to 0.99) | 0.79* | (0.54 to 0.87) | 0.65* | (0.61 to 0.97) | |
| Isolated coronary artery bypass graft | Crude OR | 1.00 | 0.93 | 1.03 | 0.73 | 0.70 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.98 | (0.81 to 1.17) | 1.08 | (0.90 to 1.28) | 0.82* | (0.68 to 0.99) | 0.92 | (0.76 to 1.11) | |
| Partial lung resection for carcinoma | Crude OR | 1.00 | 0.71 | 0.68 | 0.52 | 0.37 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.77* | (0.67 to 0.90) | 0.73* | (0.63 to 0.85) | 0.58* | (0.50 to 0.69) | 0.49* | (0.41 to 0.58) | |
| Elective major visceral surgery | ||||||||||
| Complex oesophageal surgery for carcinoma | Crude OR | 1.00 | 0.83 | 0.81 | 0.62 | 0.51 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.81* | (0.68 to 0.96) | 0.85 | (0.72 to 1.01) | 0.67* | (0.56 to 0.82) | 0.47* | (0.38 to 0.58) | |
| Pancreatic resection for carcinoma | Crude OR | 1.00 | 0.76 | 0.66 | 0.52 | 0.46 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.80* | (0.71 to 0.92) | 0.68* | (0.59 to 0.77) | 0.54* | (0.46 to 0.62) | 0.46* | (0.39 to 0.54) | |
| Colorectal resection for carcinoma | Crude OR | 1.00 | 0.92 | 0.77 | 0.72 | 0.63 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.97 | (0.91 to 1.02) | 0.85* | (0.80 to 0.90) | 0.83* | (0.78 to 0.88) | 0.75* | (0.70 to 0.80) | |
| Colorectal resection for diverticulosis | Crude OR | 1.00 | 0.86 | 0.77 | 0.65 | 0.60 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.87* | (0.80 to 0.95) | 0.87* | (0.79 to 0.95) | 0.80* | (0.72 to 0.88) | 0.74* | (0.67 to 0.82) | |
| Total nephrectomy for carcinoma | Crude OR | 1.00 | 0.92 | 0.87 | 0.75 | 0.80 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.95 | (0.79 to 1.13) | 0.89 | (0.75 to 1.06) | 0.78* | (0.64 to 0.94) | 0.80* | (0.67 to 0.97) | |
| Cystectomy for carcinoma | Crude OR | 1.00 | 0.85 | 0.89 | 0.80 | 0.70 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.85* | (0.73 to 0.98) | 0.86 | (0.74 to 1.00) | 0.80* | (0.69 to 0.93) | 0.69* | (0.58 to 0.82) | |
| Elective vascular surgery | ||||||||||
| Surgical lower extremity revascularisation for atherosclerosis | Crude OR | 1.00 | 0.86 | 0.80 | 0.73 | 0.75 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.88* | (0.81 to 0.96) | 0.85* | (0.78 to 0.94) | 0.82* | (0.75 to 0.90) | 0.82* | (0.75 to 0.91) | |
| Open repair of abdominal aortic aneurysm | Crude OR | 1.00 | 0.67 | 0.73 | 0.62 | 0.52 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.71* | (0.59 to 0.84) | 0.76* | (0.63 to 0.91) | 0.60* | (0.50 to 0.72) | 0.55* | (0.45 to 0.68) | |
| Endovascular repair of abdominal aortic aneurysm | Crude OR | 1.00 | 0.77 | 1.17 | 0.80 | 0.82 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.81 | (0.63 to 1.04) | 1.26 | (1.00 to 1.59) | 0.93 | (0.72 to 1.19) | 0.91 | (0.68 to 1.21) | |
| Carotid endarterectomy | Crude OR | 1.00 | 0.85 | 0.81 | 0.82 | 0.66 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.92 | (0.77 to 1.09) | 0.89 | (0.75 to 1.05) | 0.90 | (0.76 to 1.06) | 0.77* | (0.64 to 0.93) | |
| Elective low-risk surgery | ||||||||||
| Cholecystectomy for cholelithiasis | Crude OR | 1.00 | 0.97 | 1.00 | 0.98 | 0.84 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.98 | (0.87 to 1.09) | 1.06 | (0.95 to 1.19) | 1.07 | (0.95 to 1.19) | 0.95 | (0.85 to 1.08) | |
| Inguinal or femoral hernia repair | Crude OR | 1.00 | 0.88 | 0.75 | 0.66 | 0.43 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.94 | (0.77 to 1.14) | 0.90 | (0.72 to 1.11) | 0.83 | (0.66 to 1.04) | 0.66* | (0.51 to 0.86) | |
| Transurethral resection of prostate | Crude OR | 1.00 | 1.11 | 1.18 | 1.13 | 0.92 | ||||
| Adjusted OR (95% CI) | 1.00 | 1.06 | (0.89 to 1.25) | 1.11 | (0.93 to 1.32) | 1.08 | (0.90 to 1.28) | 0.98 | (0.82 to 1.18) | |
| Primary hip replacement for arthrosis or arthritis | Crude OR | 1.00 | 0.78 | 0.56 | 0.48 | 0.27 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.87* | (0.75 to 1.00) | 0.70* | (0.60 to 0.82) | 0.67* | (0.56 to 0.79) | 0.41* | (0.33 to 0.51) | |
| Primary knee replacement for arthrosis or arthritis | Crude OR | 1.00 | 0.79 | 0.68 | 0.59 | 0.35 | ||||
| Adjusted OR (95% CI) | 1.00 | 0.84 | (0.69 to 1.02) | 0.76* | (0.62 to 0.94) | 0.68* | (0.54 to 0.85) | 0.45* | (0.34 to 0.58) | |
Covariates used for risk adjustment are displayed in the online supplementary table 3.
*Statistically significantly lower than reference category (very low volume).