{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T01:13:36Z","timestamp":1790903616592,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T00:00:00Z","timestamp":1653868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the relationship between surgeon volume and operative morbidity and mortality for laryngectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>The Nationwide Inpatient Sample was used to identify 45,156 patients who underwent laryngectomy procedures for laryngeal or hypopharyngeal cancer between 2001 and 2011. Hospital and surgeon laryngectomy volume were modeled as categorical variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Relationships between hospital and surgeon volume and mortality, surgical complications, and acute medical complications were examined using multivariable regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Higher\u2010volume surgeons were more likely to operate at large, teaching, nonprofit hospitals and were more likely to treat patients who were white, had private insurance, hypopharyngeal cancer, low comorbidity, admitted electively, and to perform partial laryngectomy, concurrent neck dissection, and flap reconstruction. Surgeons treating more than 5 cases per year were associated with lower odds of medical and surgical complications, with a greater reduction in the odds of complications with increasing surgical volume. Surgeons in the top volume quintile (&gt;9 cases\/year) were associated with a decreased odds of in\u2010hospital mortality (OR\u00a0=\u00a00.09 [0.01\u20130.74]), postoperative surgical complications (OR\u00a0=\u00a00.58 [0.45\u20130.74]), and acute medical complications (OR\u00a0=\u00a00.49 [0.37\u20130.64]). Surgeon volume accounted for 95% of the effect of hospital volume on mortality and 16%\u201347% of the effect of hospital volume on postoperative morbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      There is a strong volume\u2010outcome relationship for laryngectomy, with reduced mortality and morbidity associated with higher surgeon and higher hospital volumes. Observed associations between hospital volume and operative morbidity and mortality are mediated by surgeon volume, suggesting that surgeon volume is an important component of the favorable outcomes of high\u2010volume hospital care.\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 133:834\u2013840, 2023\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.30229","type":"journal-article","created":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T03:35:24Z","timestamp":1653881724000},"page":"834-840","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Surgeon Volume and Laryngectomy Outcomes"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7745-3049","authenticated-orcid":false,"given":"Anirudh","family":"Saraswathula","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Matthew","family":"Austin","sequence":"additional","affiliation":[{"name":"Armstrong Institute for Patient Safety and Quality Johns Hopkins University  Baltimore Maryland U.S.A."},{"name":"Department of Anesthesiology and Critical Care Medicine Johns Hopkins University School of Medicine  Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole","family":"Fakhry","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter S.","family":"Vosler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6503-5966","authenticated-orcid":false,"given":"Rajarsi","family":"Mandal","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayne M.","family":"Koch","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marietta","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Eisele","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin D.","family":"Frick","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland U.S.A."},{"name":"Johns Hopkins Carey Business School  Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5134-9307","authenticated-orcid":false,"given":"Christine G.","family":"Gourin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland U.S.A."},{"name":"Armstrong Institute for Patient Safety and Quality Johns Hopkins University  Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,30]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa012337"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.20.1747"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.138.7.721"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3182329b97"},{"key":"e_1_2_6_6_1","unstructured":"The Leapfrog Group.Safety in Numbers: Hospital Performance on Leapfrog's Surgical Volume Standard Based on Results of the2019 Leapfrog Hospital Survey. 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