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Table 2 Characteristics of Patients Undergoing Hepatobiliary Resections from 2009 to 2015, According to Hospital Volume Categories

From: In-hospital mortality and failure to rescue following hepatobiliary surgery in Germany - a nationwide analysis

   Hospital Volume Categories
Very Low (1–10) Low (11–20) Medium (21–40) High (41–100) Very High (> 100)
Total Number of Patients N 9734 4953 4648 6555 5224
Minor Resection N 5526 (56.8) 2473 (49.9) 2002 (43.1) 2156 (32.9) 1684 (32.2)
Major Resection N 4208 (43.2) 2480 (50.1) 2646 (56.9) 4399 (67.1) 3540 (67.8)
Annual Number of Hospitalsa Mean ± STD 403.3 ± 12.3 50.1 ± 5.2 24 ± 2.2 14.6 ± 1.6 5.4 ± 1.0
Annual Hospital Volume Median (IQR) 3 (1–5) 13 (12–16) 27 (23–31) 63.5 (49–78) 119.5 (108–141)
Hospital to hospital transferb
 Transfer-in N (%) 176 (1.81) 109 (2.20) 142 (3.06) 418 (6.38) 322 (6.16)
 Transfer-out N (%) 448 (4.60) 205 (4.14) 187 (4.02) 318 (4.85) 206 (3.94)
Demographics
 Age (Years) Mean ± STD 65.09 ± 0.12 64.29 ± 0.17 62.9 ± 0.19 61.46 ± 0.16 60.4 ± 10.18
 Age ≥ 65 Years N (%) 5683 (58.38) 2785 (56.23) 2419 (52.04) 3098 (47.26) 2301 (44.05)
 Female Sex N (%) 4248 (43.64) 2098 (42.36) 1947 (41.89) 2837 (43.28) 2395 (45.85)
Medical Indication
 Metastatic Disease N (%) 4664 (47.91) 2439 (49.24) 2221 (47.78) 2764 (42.17) 1921 (36.77)
 Malignant Hepatobiliary Neoplasm N (%) 2553 (26.23) 1442 (29.11) 1444 (31.07) 2362 (36.03) 2210 (42.3)
 Benign Hepatobiliary Disease N (%) 711 (7.3) 344 (6.95) 366 (7.87) 583 (8.89) 452 (8.65)
 Other Medical Indication N (%) 1806 (18.55) 728 (14.7) 617 (13.27) 846 (12.91) 641 (12.27)
Comorbidities
 Chronic Heart Disease N (%) 1152 (11.83) 573 (11.57) 466 (10.03) 569 (8.68) 506 (9.69)
 Hypertension N (%) 4654 (47.81) 2197 (44.36) 1980 (42.6) 2767 (42.21) 2244 (42.96)
 Peripheral Vascular Disease N (%) 167 (1.72) 71 (1.43) 57 (1.23) 90 (1.37) 74 (1.42)
 Chronic Lung Disease N (%) 737 (7.57) 299 (6.04) 301 (6.48) 347 (5.29) 327 (6.26)
 Chronic Liver Disease N (%) 947 (9.73) 514 (10.38) 541 (11.64) 843 (12.86) 798 (15.28)
 Severe Kidney Disease N (%) 853 (8.76) 383 (7.73) 355 (7.64) 414 (6.32) 258 (4.94)
 Diabetes Mellitus N (%) 1969 (20.23) 978 (19.75) 851 (18.31) 1151 (17.56) 1465 (28.04)
 Obesity N (%) 767 (7.88) 383 (7.73) 321 (6.91) 494 (7.54) 477 (9.13)
 Coagulopathy N (%) 109 (1.12) 67 (1.35) 69 (1.48) 79 (1.21) 27 (0.52)
Type of Surgery
 Trisectionectomy N (%) 463 (4.76) 393 (7.93) 515 (11.08) 989 (15.09) 926 (17.73)
 Hemihepatectomy N (%) 3745 (38.47) 2087 (42.14) 2131 (45.85) 3410 (52.02) 2614 (50.04)
 Multiple Segmentectomy N (%) 3308 (33.98) 1517 (30.63) 1186 (25.52) 1272 (19.41) 1035 (19.81)
 Bisegmentectomy N (%) 2218 (22.79) 956 (19.3) 816 (17.56) 884 (13.49) 649 (12.42)
Extent of Surgery
 Resection of Arteries/Veins N (%) 119 (1.22) 101 (2.04) 147 (3.16) 431 (6.58) 398 (7.62)
 Biliodigestive Anastomosis N (%) 323 (3.32) 299 (6.04) 375 (8.07) 842 (12.85) 946 (18.11)
 Resection Other Organ N (%) 781 (8.02) 494 (9.97) 457 (9.83) 626 (9.55) 569 (10.89)
  1. aThat Performed at Least one Hepatobiliary Resection
  2. bOnly Acute Care Hospitals. STD Standard Deviation, IQR Interquartile Range (25th to 75th percentile)