Data strategies and tactics used to create and promulgate robust databases across a wide organization are subject to a number of constraints and challenges.This presentation reviews lessons learned from one company in...Data strategies and tactics used to create and promulgate robust databases across a wide organization are subject to a number of constraints and challenges.This presentation reviews lessons learned from one company in the oil and gas industry,and illustrates how that company met and overcame challenges during the database design and implementation phases.展开更多
AIM: To determine whether institutional laparoscopy cholecystectomy(LC) volume affects rates of mortality, conversion to open surgery, bile leakage and bile duct injury(BDI).METHODS: Eligible studies were prospective ...AIM: To determine whether institutional laparoscopy cholecystectomy(LC) volume affects rates of mortality, conversion to open surgery, bile leakage and bile duct injury(BDI).METHODS: Eligible studies were prospective or retrospective cohort studies that provided data on outcomes from consecutive LC procedures in single institutions. Relevant outcomes were mortality, conversion to open surgery, bile leakage and BDI. We performed a Medline search and extracted data. A regression analysis using generalized estimating equations were used to determine the influence of annual institutional LC caseload on outcomes. A sensitivity analysis was performed including only those studies that were published after 1995.RESULTS: Seventy-three cohorts(127404 LC procedures) were included. Average complication rates were 0.06% for mortality, 3.23% for conversion, 0.44% for bile leakage and 0.28% for bile duct injury. Annual institutional caseload did not influence rates of mortality(P = 0.142), bile leakage(P = 0.111) or bile duct injury(P = 0.198) although increasing caseload was associated with reduced incidence of conversion(P = 0.019). Results from the sensitivity analyses were similar.CONCLUSION: Institutional volume is a determinant of LC complications. It is unclear whether volume is directly linked to complication rates or whether it is an index for protocolised care.展开更多
文摘Data strategies and tactics used to create and promulgate robust databases across a wide organization are subject to a number of constraints and challenges.This presentation reviews lessons learned from one company in the oil and gas industry,and illustrates how that company met and overcame challenges during the database design and implementation phases.
文摘AIM: To determine whether institutional laparoscopy cholecystectomy(LC) volume affects rates of mortality, conversion to open surgery, bile leakage and bile duct injury(BDI).METHODS: Eligible studies were prospective or retrospective cohort studies that provided data on outcomes from consecutive LC procedures in single institutions. Relevant outcomes were mortality, conversion to open surgery, bile leakage and BDI. We performed a Medline search and extracted data. A regression analysis using generalized estimating equations were used to determine the influence of annual institutional LC caseload on outcomes. A sensitivity analysis was performed including only those studies that were published after 1995.RESULTS: Seventy-three cohorts(127404 LC procedures) were included. Average complication rates were 0.06% for mortality, 3.23% for conversion, 0.44% for bile leakage and 0.28% for bile duct injury. Annual institutional caseload did not influence rates of mortality(P = 0.142), bile leakage(P = 0.111) or bile duct injury(P = 0.198) although increasing caseload was associated with reduced incidence of conversion(P = 0.019). Results from the sensitivity analyses were similar.CONCLUSION: Institutional volume is a determinant of LC complications. It is unclear whether volume is directly linked to complication rates or whether it is an index for protocolised care.
