Table 1.
Characteristics of patients undergoing rectal resection for rectal cancer in 2012–2015, according to hospital volume quintile
| Hospital volume quintile | ||||||
|---|---|---|---|---|---|---|
| Very low | Low | Medium | High | Very high | P ‡ | |
| No. of hospitals | 550 | 197 | 137 | 101 | 61 | |
| Total no. of patients | 12 864 | 12 738 | 12 989 | 12 916 | 12 842 | |
| In‐hospital deaths | 687 (5·3) | 562 (4·4) | 477 (3·7) | 443 (3·4) | 337 (2·6) | < 0·001§ |
| No. of patients over 4‐year period * | 23·4(14·9) | 64·7(9·0) | 94·8(8·6) | 127·9(12·0) | 210·5(64·3) | |
| Annual volume per hospital * | 5·8 | 16·2 | 23·7 | 32·0 | 52·6 | |
| Age (years) * | 70·3(11·2) | 69·1(11·2) | 68·2(11·5) | 67·5(11·5) | 66·6(11·7) | < 0·001§ |
| ≤ 59† | 2415 (16·3) | 2660 (17·9) | 2995 (20·2) | 3233 (21·8) | 3523 (23·8) | |
| 60–74† | 5253 (18·6) | 5582 (19·8) | 5701 (20·2) | 5816 (20·6) | 5826 (20·7) | < 0·001 |
| ≥ 75† | 5196 (24·3) | 4496 (21·1) | 4293 (20·1) | 3867 (18·1) | 3493 (16·4) | |
| No. of women | 4991 (38·8) | 4813 (37·8) | 4929 (37·9) | 4617 (35·7) | 4649 (36·2) | < 0·001§ |
| Co‐morbidity score * | 102·3(5·2) | 102·1(5·3) | 101·7(5·0) | 101·6(4·9) | 101·5(4·9) | < 0·001§ |
| Length of hospital stay (days) * | 21·7(14·6) | 21·6(15·2) | 20·5(14·5) | 20·6(15·8) | 19·7(15·0) | < 0·001§ |
| Cancer location | ||||||
| Rectosigmoid | 2281 | 1514 | 1201 | 1197 | 1122 | |
| Mortality | 129 (5·7) | 78 (5·2) | 56 (4·7) | 43 (3·6) | 31 (2·8) | 0·001 |
| Rectum | 10 583 | 11 224 | 11 788 | 11 719 | 11 720 | |
| Mortality | 558 (5·3) | 484 (4·3) | 421 (3·6) | 400 (3·4) | 306 (2·6) | < 0·001 |
| Type of surgery | ||||||
| Non‐sphincter‐preserving rectal resection | 2548 | 2686 | 2804 | 2808 | 2672 | |
| Mortality | 134 (5·3) | 134 (5·0) | 106 (3·8) | 116 (4·1) | 76 (2·8) | < 0·001 |
| Sphincter‐preserving resection and perianal anastomosis | 850 | 1020 | 980 | 821 | 972 | |
| Mortality | 36 (4·2) | 28 (2·7) | 19 (1·9) | 10 (1·2) | 14 (1·4) | < 0·001 |
| Sphincter‐preserving low anterior resection | 5159 | 5383 | 5914 | 6081 | 6351 | |
| Mortality | 245 (4·7) | 214 (4·0) | 202 (3·4) | 172 (2·8) | 155 (2·4) | < 0·001 |
| Sphincter‐preserving anterior resection | 3670 | 3269 | 2937 | 2902 | 2602 | |
| Mortality | 210 (5·7) | 149 (4·6) | 125 (4·3) | 122 (4·2) | 73 (2·8) | < 0·001 |
| Other resection (sigmoid/left) | 497 | 261 | 258 | 237 | 197 | |
| Mortality | 54 (10·9) | 31 (11·9) | 19 (7·4) | 18 (7·6) | 19 (9·6) | 0·390 |
| Tubular/segmental resection | 140 | 119 | 96 | 67 | 48 | |
| Mortality | n.s. | n.s. | 6 (6·3) | n.s. | n.s. | – |
| Sphincter‐preserving (low anterior) resection | 9679 | 9672 | 9831 | 9804 | 9925 | |
| Mortality | 491 (5·1) | 391 (4·0) | 346 (3·5) | 304 (3·1) | 242 (2·4) | < 0·001 |
| Any laparoscopic resection | 3252 | 3672 | 4026 | 4202 | 3715 | |
| Mortality | 99 (3·0) | 91 (2·5) | 84 (2·1) | 66 (1·6) | 61 (1·6) | < 0·001 |
| Laparoscopic sphincter‐preserving low anterior resection | 2635 | 2985 | 3243 | 3415 | 3097 | |
| Mortality | 65 (2·5) | 63 (2·1) | 60 (1·9) | 47 (1·4) | 48 (1·5) | 0·017 |
Values in parentheses are percentages of total in the relevant quintile unless indicated otherwise;
*
values are mean(s.d.);
†
values in parentheses are percentage of total in that age group. n.s., Not stated owing to German data protection legislation.
‡
χ2 test for difference between subgroups, except
§
non‐parametric test for trend.