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    National Trends in Elective Ileal Pouch-Anal Anastomosis for Ulcerative Colitis

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    Authors
    Hoang, Chau Maggie
    Faculty Advisor
    Karim Alavi, MD MPH
    Academic Program
    Master of Science in Clinical Investigation
    UMass Chan Affiliations
    Department of Surgery, Division of Colon and Rectal Surgery
    Document Type
    Master's Thesis
    Publication Date
    2018-06-05
    Keywords
    pouch
    IPAA
    ulcerative colitis
    ileal pouch-anal anastomosis
    Digestive System Diseases
    Health Services Administration
    Health Services Research
    Surgery
    Surgical Procedures, Operative
    
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    Abstract
    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/M27H74
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/32363
    Rights
    Copyright is held by the author, with all rights reserved.
    ae974a485f413a2113503eed53cd6c53
    10.13028/M27H74
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