{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T23:12:54Z","timestamp":1787872374803,"version":"build-2784847793"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2021,5,15]],"date-time":"2021-05-15T00:00:00Z","timestamp":1621036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A minimum volume threshold of at least six procedures per annum per surgeon has been set in UK and European guidelines for adrenal surgery. The aim of this study was to investigate outcomes for adrenal surgery in England relative to annual surgeon and hospital trust volume.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were extracted from the Hospital Episodes Statistics database for England. A 6-year period (January 2013 to December 2018 inclusive) for all adult admissions for unilateral adrenal surgery was used. The primary outcome measure was an emergency readmission within 30\u2009days of discharge following surgery. Procedures were categorized as open or minimally invasive surgery for analysis. Multilevel modelling was used to adjust for hierarchy and potential confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Data for 4189 adrenalectomies were identified. Only one third of surgeons (who operated on just over a half of all patients) performed at least six procedures in the year prior to the index procedure. For open surgery, emergency readmission rates fell significantly from 15.2 to 6.4 per cent for surgeons and from 13.2 to 6.1 per cent for trusts between the lowest- and highest-volume categories. Significant, but less dramatic falls were also seen for minimally invasive surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A volume\u2013outcome effect was identified for adrenal surgery in England. Minimum volume thresholds should be set, although these may need to be more ambitious than the current threshold if outcomes are to be optimized.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjs\/znab142","type":"journal-article","created":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T15:12:23Z","timestamp":1617721943000},"page":"1112-1119","source":"Crossref","is-referenced-by-count":28,"title":["Volume\u2013outcome relationship for adrenalectomy: analysis of an administrative dataset for the Getting It Right First Time Programme"],"prefix":"10.1093","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9597-5446","authenticated-orcid":false,"given":"W K","family":"Gray","sequence":"first","affiliation":[{"name":"Getting It Right First Time Programme, NHS England and NHS Improvement , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Day","sequence":"additional","affiliation":[{"name":"Getting It Right First Time Programme, NHS England and NHS Improvement , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T W R","family":"Briggs","sequence":"additional","affiliation":[{"name":"Getting It Right First Time Programme, NHS England and NHS Improvement , London, UK"},{"name":"Royal National Orthopaedic Hospital, Stanmore , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J A H","family":"Wass","sequence":"additional","affiliation":[{"name":"Getting It Right First Time Programme, NHS England and NHS Improvement , London, UK"},{"name":"Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University , Churchill Hospital, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Lansdown","sequence":"additional","affiliation":[{"name":"Getting It Right First Time Programme, NHS England and NHS Improvement , London, UK"},{"name":"Department of Endocrine Surgery , St James's University Hospital, Leeds Teaching 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