National Trends in Elective Ileal Pouch-Anal Anastomosis for Ulcerative Colitis
Authors
Hoang, Chau MaggieFaculty Advisor
Karim Alavi, MD MPHAcademic Program
Master of Science in Clinical InvestigationUMass Chan Affiliations
Department of Surgery, Division of Colon and Rectal SurgeryDocument Type
Master's ThesisPublication Date
2018-06-05Keywords
pouchIPAA
ulcerative colitis
ileal pouch-anal anastomosis
Digestive System Diseases
Health Services Administration
Health Services Research
Surgery
Surgical Procedures, Operative
Metadata
Show full item recordAbstract
Background: Recent national trends and distribution of ileal pouch-anal anastomosis (IPAA) procedures for patients with ulcerative colitis (UC) are unknown. We examined the frequency of use of elective IPAA procedures among patients with UC and the distribution of IPAA procedures across more than 140 U.S. academic medical centers and their affiliates. Methods: Data were obtained from the University HealthSystem Consortium for patients with a primary diagnosis of UC admitted electively between 2012 and 2015. Results: The mean age of the study population (n=6,875) was 43 years and 57% were men. Among these, one-third (n=2,307) underwent an IPAA, while two-thirds (n=4,568) underwent colectomy, proctectomy, proctocolectomy or other procedures. The proportion of IPAA cases among all elective admissions was relatively stable at 33-35% during the years under study. A total of 131 hospitals, out of 279 hospitals participating in the UHC, performed IPAA. The median number of IPAA cases performed annually was 1.9 [IQR 0.8 – 4.3]. Nearly one half (48%) of these cases were performed by the top ten hospitals. Overall, only a total of 30 centers performed ³ five elective IPAA cases annually. Conclusions: Although the frequency of elective IPAA surgery in recent years has been stable, nearly one half of all IPAA cases was performed at ten hospitals. The concentration of IPAA cases at high-volume centers, and the steady number of cases performed annually, have potential implications for fellowship training, patient clinical outcomes and access to care.DOI
10.13028/M27H74Permanent Link to this Item
http://hdl.handle.net/20.500.14038/32363Rights
Copyright is held by the author, with all rights reserved.ae974a485f413a2113503eed53cd6c53
10.13028/M27H74