Bigger Hospital, Better Odds

Ovarian cancer patients have higher risks in busy hospitals but also have better chances

(RxWiki News) Experience and preparedness are key elements to successful health care. Busy hospital staff may have full hands, but they’re also well equipped to handle any medical surprises.

A new study showed that women who have ovarian cancer surgery at high volume hospitals have better outcomes than at low volume hospitals.

The reason is not because of a higher rate of complications in low volume hospitals, but because high volume hospitals are better equipped to treat those complications.

"Before surgery, research your hospital's success rates."

Jason Wright, MD, gynecological oncologist and Assistant Professor of Women’s Health at Columbia University Medical Center in New York City, led investigations into ovarian cancer surgeries.

Dr. Wright said, “It is widely documented that surgical volume (number of surgeries in a hospital) has an important effect on outcomes following surgery.”

For the study, researchers looked at the cases of 36,624 women aged 18-90, hospitalized with ovarian cancer between 1988-2009.

Complications from ovarian cancer surgery to remove one or both ovaries were more common in high-volume hospitals, but rescue rates in the high-volume hospitals were more successful as well.

Based on the size and surgical capacity of the 1,166 hospitals reviewed, researchers found major complications occurred in:

  • 20 percent of cases in low-volume hospitals
  • 23 percent of cases in intermediate-volume hospitals
  • 25 percent of cases in high-volume hospitals

Patients who experienced complications at low-volume hospitals had a 48 percent increased chance of dying compared to those at high-volume hospitals.

Failure to rescue patients from complications rates were:

  • 8 percent in low-volume hospitals
  • 5 percent in high-volume hospitals

Overall, less than 2 percent of the entire group died due to complications in any hospital.

Dr. Wright said, “In short, high-volume hospitals are better able to rescue patients with complications following ovarian cancer surgery.”

Authors concluded, “The reduction in mortality does not appear to be the result of lower complication rates but rather a result of the ability of high-volume hospitals to rescue patients with complications.”

Treatment and surgical complication protocol for all-volume hospitals may help to stabilize all ovarian cancer surgical patient outcomes.

This study was published in November in the Journal of Clinical Oncology.

Research for this study was supported by a grant from the National Cancer Institute.

No conflicts of interest were reported.

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Review Date: 
November 12, 2012