Choosing a hospital that either performs many cystectomies - the surgical removal of the urinary bladder - or has a high nurse-to-patient ratio minimizes post-operative complications after the procedure, according to a new study.
The report, published in the September 1, 2005 issue of CANCER, a peer-reviewed journal of the American Cancer Society, indicates that post-operative mortality and complications were reduced by up to 75 percent in the best-case scenarios.
This year more than 63,000 Americans will get bladder cancer, with over 20 percent becoming invasive, leading to more than 13,000 deaths. The standard of care for invasive bladder cancer is cystectomy, which itself is associated with a mortality rate of about 2 percent, making it what doctors consider a moderate-risk surgery.
Studies show a clear survival benefit for patients who have high-risk cancer surgeries at hospitals that commonly perform the procedures. However, most cancer-related surgeries are moderate risk. In this category, studies analyzing the benefit of choosing a high procedure volume hospital have had inconsistent results.
Led by Linda S. Elting, Dr.P.H., of the University of Texas M. D. Anderson Cancer Center in Houston, researchers investigated the relationship between hospitals' procedure volume and their post-operative mortality and morbidity. Researchers also analyzed data for hospital-related risk factors to help explain this relationship.