21287
2020
eng
310
319
2
4
article
1
--
--
--
Nationwide in‐hospital mortality rate following rectal resection for rectal cancer according to annual hospital volume in Germany
Background
The impact of hospital volume after rectal cancer surgery is seldom investigated. This study aimed to analyse the impact of annual rectal cancer surgery cases per hospital on postoperative mortality and failure to rescue.
Methods
All patients diagnosed with rectal cancer and who had a rectal resection procedure code from 2012 to 2015 were identified from nationwide administrative hospital data. Hospitals were grouped into five quintiles according to caseload. The absolute number of patients, postoperative deaths and failure to rescue (defined as in‐hospital mortality after a documented postoperative complication) for severe postoperative complications were determined.
Results
Some 64 349 patients were identified. The overall in‐house mortality rate was 3·9 per cent. The crude in‐hospital mortality rate ranged from 5·3 per cent in very low‐volume hospitals to 2·6 per cent in very high‐volume centres, with a distinct trend between volume categories (P < 0·001). In multivariable logistic regression analysis using hospital volume as random effect, very high‐volume hospitals (53 interventions/year) had a risk‐adjusted odds ratio of 0·58 (95 per cent c.i. 0·47 to 0·73), compared with the baseline in‐house mortality rate in very low‐volume hospitals (6 interventions per year) (P < 0·001). The overall postoperative complication rate was comparable between different volume quintiles, but failure to rescue decreased significantly with increasing caseload (15·6 per cent after pulmonary embolism in the highest volume quintile versus 38 per cent in the lowest quintile; P = 0·010).
Conclusion
Patients who had rectal cancer surgery in high‐volume hospitals showed better outcomes and reduced failure to rescue rates for severe complications than those treated in low‐volume hospitals.
BJS Open
10.1002/bjs5.50254
urn:nbn:de:bvb:20-opus-212878
swordwue
2020-10-06T18:18:13+00:00
attachment; filename=deposit.zip
520cd02ed83e423009a9c892ba4236f1
BJS Open 2020, 4(2):310–319. DOI: 10.1002/bjs5.50254
false
true
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
J. Diers
J. Wagner
P. Baum
S. Lichthardt
C. Kastner
N. Matthes
H. Matthes
C.‐T. Germer
S. Löb
A. Wiegering
eng
uncontrolled
rectal resection
eng
uncontrolled
rectal cancer
eng
uncontrolled
mortality rate
Medizin und Gesundheit
open_access
Klinik und Poliklinik für Allgemein-, Viszeral-, Gefäß- und Kinderchirurgie (Chirurgische Klinik I)
Theodor-Boveri-Institut für Biowissenschaften
Import
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/21287/BJS5_BJS550254.pdf
20438
2019
eng
672-677
5
3
article
1
2020-05-18
--
--
Nationwide in-hospital mortality following colonic cancer
resection according to hospital volume in Germany
Background:
Colonic cancer is the most common cancer of the gastrointestinal tract. The aim of this study was to determine mortality rates following colonic cancer resection and the effect of hospital caseload on in-hospital mortality in Germany.
Methods:
Patients admitted with a diagnosis of colonic cancer undergoing colonic resection from 2012 to 2015 were identifed from a nationwide registry using procedure codes. The outcome measure was in-hospital mortality. Hospitals were ranked according to their caseload for colonic cancer resection, and patients were categorized into five subgroups on the basis of hospital volume.
Results:
Some 129 196 colonic cancer resections were reviewed. The overall in-house mortality rate was 5⋅8 per cent, ranging from 6⋅9 per cent (1775 of 25 657 patients) in very low-volume hospitals to 4⋅8 per cent (1239 of 25 825) in very high-volume centres (P < 0⋅001). In multivariable logistic regression analysis the risk-adjusted odds ratio for in-house mortality was 0⋅75 (95 per cent c.i. 0⋅66 to 0⋅84) in very high-volume hospitals performing a mean of 85⋅0 interventions per year, compared with that in very low-volume hospitals performing a mean of only 12⋅7 interventions annually, after adjustment for sex, age, co-morbidity, emergency procedures, prolonged mechanical ventilation and transfusion.
Conclusion:
In Germany, patients undergoing colonic cancer resections in high-volume hospitals had with improved outcomes compared with patients treated in low-volume hospitals
BJS Open
10.1002/bjs5.50173
urn:nbn:de:bvb:20-opus-204385
BJS Open (2019) 3:5, 672-677. https://doi.org/10.1002/bjs5.50173
false
true
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
J. Diers
J. Wagner
P. Baum
S. Lichthardt
C. Kastner
N. Matthes
S. Löb
H. Matthes
C.-T. Germer
A. Wiegering
Medizin und Gesundheit
open_access
Klinik und Poliklinik für Allgemein-, Viszeral-, Gefäß- und Kinderchirurgie (Chirurgische Klinik I)
Theodor-Boveri-Institut für Biowissenschaften
Förderzeitraum 2019
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/20438/Diers_BJSOpen_2019.pdf
14840
2015
eng
12125-12153
20
article
1
2017-05-11
--
--
Post-synthetic shaping of porosity and crystal structure of Ln-Bipy-MOFs by thermal treatment
The reaction of anhydrous lanthanide chlorides together with 4,4'-bipyridine yields the MOFs \(^{2}\)\(_{∞}\)[Ln\(_{2}\)Cl\(_{6}\)(bipy)\(_{3}\)]*2bipy, with Ln = Pr-Yb, bipy = 4,4'-bipyridine, and \(^{3}\)\(_{∞}\)[La\(_{2}\)Cl\(_{6}\)(bipy)\(_{5}\)]*4bipy. Post-synthetic thermal treatment in combination with different vacuum conditions was successfully used to shape the porosity of the MOFs. In addition to the MOFs microporosity, a tuneable mesoporosity can be implemented depending on the treatment conditions as a surface morphological modification. Furthermore, thermal treatment without vacuum results in several identifiable crystalline high-temperature phases. Instead of collapse of the frameworks upon heating, further aggregation under release of bipy is observed. \(^{3}\)\(_{∞}\)[LaCl\(_{3}\)(bipy)] and \(^{2}\)\(_{∞}\)[Ln\(_{3}\)Cl\(_{9}\)(bipy)\(_{3}\)], with Ln = La, Pr, Sm, and \(^{1}\)\(_{∞}\)[Ho\(_{2}\)Cl\(_{6}\)(bipy)\(_{2}\)] were identified and characterized, which can also exhibit luminescence. Besides being released upon heating, the linker 4,4'-bipyridine can undergo activation of C-C bonding in ortho-position leading to the in-situ formation of 4,4':2',2 '':4 '',4'''-quaterpyridine (qtpy). qtpy can thereby function as linker itself, as shown for the formation of the network \(^{2}\)\(_{∞}\)[Gd\(_{2}\)Cl\(_{6}\)(qtpy)\(_{2}\)(bipy)\(_{2}\)]*bipy. Altogether, the manuscript elaborates the influence of thermal treatment beyond the usual activation procedures reported for MOFs.
Molecules
10.3390/molecules200712125
urn:nbn:de:bvb:20-opus-148404
Molecules 2015, 20, 12125-12153. DOI: 10.3390/molecules200712125
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Philipp R. Matthes
Fabian Schönfeld
Sven H. Zottnick
Klaus Müller-Buschbaum
eng
uncontrolled
energy transfer
eng
uncontrolled
ligand
eng
uncontrolled
Ln-MOFs
eng
uncontrolled
luminescence crystal structure
eng
uncontrolled
metal-organic frameworks
eng
uncontrolled
shaping of porosity
eng
uncontrolled
thermal treatment
eng
uncontrolled
luminescence
eng
uncontrolled
crystal scructure
eng
uncontrolled
coordination polymers
eng
uncontrolled
solid state
Anorganische Chemie
open_access
Institut für Anorganische Chemie
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/14840/019_Matthes_Molecules.pdf