Association of anesthesiologists' hepato-pancreato-biliary volume and outcomes for other surgeries.

BACKGROUND

We examined the association between care by high-volume (HV) HPB anesthesiologists and post-operative outcomes for other non-HPB surgeries.

METHOD: We conducted a population-based retrospective cohort study of adults undergoing non-cardiac, non-orthopedic surgeries. The exposure was care by HV HPB anesthesiologists (≥6 HPB cases/year). The outcome was 90-day major morbidity (MM - Clavien-Dindo grade 3-5).

RESULTS

Among 385,944 non-HPB surgeries, 23.1% were performed with HV HPB anesthesiologists and 18.4% had 90-day MM. After adjustment, care by HV HPB anesthesiologist was not associated with 90-day MM (adjusted odds ratio [aOR] 0.99, 95%CI 0.98-1.01). At the hospital level, there was no association between the hospital rate of care by HV HPB anesthesiologists and the hospital rate of 90-day MM (adjusted rate ratio 0.98, 95%CI 0.96-1.01).

CONCLUSION AND RELEVANCE: HV HPB anesthesiology care was not associated with worse outcomes for most non-HPB surgeries, at the individual surgery or the hospital level. There was procedure-specific heterogeneity.