https://scholars.lib.ntu.edu.tw/handle/123456789/493688
標題: | Does Categorization Method Matter in Exploring Volume-Outcome Relation? A Multiple Categorization Methods Comparison in Coronary Artery Bypass Graft Surgery Surgical Site Infection | 作者: | Yu T.-H. YU-CHI TUNG Chung K.-P. |
公開日期: | 2015 | 出版社: | Mary Ann Liebert Inc. | 卷: | 16 | 期: | 4 | 起(迄)頁: | 466-472 | 來源出版物: | Surgical Infections | 摘要: | Background: Volume-infection relation studies have been published for high-risk surgical procedures, although the conclusions remain controversial. Inconsistent results may be caused by inconsistent categorization methods, the definitions of service volume, and different statistical approaches. The purpose of this study was to examine whether a relation exists between provider volume and coronary artery bypass graft (CABG) surgical site infection (SSI) using different categorization methods. Methods: A population-based cross-sectional multi-level study was conducted. A total of 10,405 patients who received CABG surgery between 2006 and 2008 in Taiwan were recruited. The outcome of interest was surgical site infection for CABG surgery. The associations among several patient, surgeon, and hospital characteristics was examined. The definition of surgeons' and hospitals' service volume was the cumulative CABG service volumes in the previous year for each CABG operation and categorized by three types of approaches: Continuous, quartile, and k-means clustering. Results: The results of multi-level mixed effects modeling showed that hospital volume had no association with SSI. Although the relation between surgeon volume and surgical site infection was negative, it was inconsistent among the different categorization methods. Conclusions: Categorization of service volume is an important issue in volume-infection study. The findings of the current study suggest that different categorization methods might influence the relation between volume and SSI. The selection of an optimal cutoff point should be taken into account for future research. ? 2015, Mary Ann Liebert, Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84937857352&doi=10.1089%2fsur.2014.075&partnerID=40&md5=f1a1391ddbaf6637d24a26b3a298dc50 https://scholars.lib.ntu.edu.tw/handle/123456789/493688 |
ISSN: | 1096-2964 | DOI: | 10.1089/sur.2014.075 | SDG/關鍵字: | aged; Article; classification; community hospital; coronary artery bypass graft; cross-sectional study; female; health service; high volume hospital; hospital; human; incidence; length of stay; low volume hospital; major clinical study; male; non profit hospital; priority journal; surgeon; surgical infection; Taiwan; adverse effects; cluster analysis; coronary artery bypass graft; middle aged; statistics and numerical data; Surgical Wound Infection; Aged; Cluster Analysis; Coronary Artery Bypass; Cross-Sectional Studies; Female; Hospitals; Humans; Male; Middle Aged; Surgeons; Surgical Wound Infection |
顯示於: | 健康政策與管理研究所 |
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