Author:
Ronellenfitsch U.,Meisenbacher K.,Ante M.,Grilli M.,Böckler D.
Abstract
AbstractBackgroundAn inverse association between the case volume per hospital and surgeon and perioperative mortality has been shown for many surgical interventions. There are numerous studies on this issue for the open treatment of infrarenal aortic aneurysms.AimTo present the available data on the association between the case volume per hospital and surgeon and perioperative mortality in the elective open repair of infrarenal aortic aneurysms in a systematic review.Materials and methodsUsing the PubMed, Cochrane Library, Web of Science Core Collection, CINAHL, Current Contents Medicine (CCMed), and ClinicalTrials.gov databases, a systematic search was performed using defined keywords. From the search results, all original papers were included that compared the elective open repair of an infrarenal aortic aneurysm in a “high volume” center with a “low volume” center or by a “high volume” surgeon with a “low volume” surgeon, as defined in the respective study.ResultsAfter deduplication, the literature search yielded 1021 hits of which 60 publications met the inclusion criteria. Of these, 37/43 studies showed a lower mortality in “high volume” compared to “low volume” centers and 14/17 comparisons showed a lower mortality for “high volume” compared to “low volume” surgeons. The effect measures, usually odds ratios, ranged from 0.37 to 0.99 for volume per hospital and 0.31 to 0.92 for volume per surgeon. Regarding the threshold values for the definition of “high volume” and “low volume,” a clear heterogeneity was shown between the individual studies.DiscussionThe available data on the association between the case volume per hospital and surgeon and perioperative mortality in the elective open repair of infrarenal aortic aneurysms show that interventions performed in “high volume” centers or by “high volume” surgeons are associated with lower mortality. To ensure the best possible outcome in terms of low perioperative mortality in the open repair of infrarenal aortic aneurysms, the aim should be centralization with high case volume per hospital and surgeon.
Funder
Ruprecht-Karls-Universität Heidelberg
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine,Surgery
Reference65 articles.
1. Chaikof EL, Dalman RL, Eskandari MK, Jackson BM, Lee WA, Mansour MA et al (2018) The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. J Vasc Surg 67(1):2–77.e2
2. Debus ES, Heinemann F, Gross-Fengels W, Mahlmann A, Muhl E, Pfister K, Roth S, Stroszczynski C, Walther A, Weiss N, Wilhelmi M, Grundmann RT (2018) S3 Leitlinie zu Screening, Diagnostik, Therapie und Nachsorge des Bauchaortenaneurysmas. AWMF-Registernummer 004–14. https://www.awmf.org/uploads/tx_szleitlinien/004-014l__S3_Bauchaortenaneurysma_2018-08.pdf. Zugegriffen: 26.7.2020
3. Augurzky B, Hentschker C, Pilny A, Wübker A (2018) Krankenhausreport 2018: Schriftenreihe zur Gesundheitsanalyse. Band 11. https://magazin.barmer.de/wp-content/uploads/2018/08/dl-krankenhausreport-komplett.pdf. Zugegriffen: 26.7.2020
4. Schmitz-Rixen T, Steffen M, Böckler D, Grundmann RT (2017) Versorgung des abdominellen Aortenaneurysmas (AAA). Gefäßchirurgie 24(2):162–172
5. Birkmeyer JD, Dimick JB, Staiger DO (2006) Operative mortality and procedure volume as predictors of subsequent hospital performance. Ann Surg 243(3):411–417
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献