Hospital surgical volume-outcome relationship of postoperative morbidity for ileocolic resection in Crohn's disease: A French nationwide study of 4,205 patients. - Université de Lille Accéder directement au contenu
Article Dans Une Revue Journal of Crohn's and Colitis Année : 2024

Hospital surgical volume-outcome relationship of postoperative morbidity for ileocolic resection in Crohn's disease: A French nationwide study of 4,205 patients.

Résumé

Background and Aims Despite the development of medical therapy, nearly 50% of patients with Crohn’s disease [CD] undergo surgery during their lifetime. Several studies have suggested some risk factors for postoperative morbidity [POM] after ileocolic resection [ICR]. However, the impact of surgical hospital volume on POM in CD has not been extensively studied. This study aimed to assess the impact of surgical hospital volume on POM after ICR for CD. Methods All patients with CD who underwent ICR in France between 2013 and 2022 were identified in the French Database, Programme de Médicalisation des Systèmes d’Information. Using the Chi-square automatic interaction detector, we determined the cut-off value to split high-surgical-volume [≥6 ICRs/year] and low-surgical-volume centres [<6 ICRs/year]. The primary outcome was the evaluation of major POM during hospitalization. POM was evaluated according to the surgical volume centre. The Elixhauser comorbidity index [ECI] was used to categorize the comorbidities of patients. Results A total of 4205 patients were identified, and the major POM during hospitalization was significantly [p = 0.0004] lower in the high-surgical-volume [6.2%] compared to low-surgical-volume centres [9.1%]. After multivariate analysis, independent factors associated with major POM were surgical hospital volume [p = 0.024], male sex [p = 0.029], ECI ≥ 1 [p < 0.001], and minor POM [p < 0.001]. Conclusion Major POM after ICR for CD is closely associated with surgical hospital volume. Centralization of surgery for CD is desirable, especially in patients with major comorbidities.
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Dates et versions

hal-04495462 , version 1 (08-03-2024)

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Thibaut Bitterlin, Caroline Valibouze, Xavier Lenne, Amelie Bruandet, Pierre Desreumaux, et al.. Hospital surgical volume-outcome relationship of postoperative morbidity for ileocolic resection in Crohn's disease: A French nationwide study of 4,205 patients.. Journal of Crohn's and Colitis, 2024, Journal of Crohn's and Colitis, ⟨10.1093/ecco-jcc/jjae010⟩. ⟨hal-04495462⟩

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