Hospital volume of thoracoabdominal aneurysm repair does not affect mortality in California

Anna Weiss, Jamie Anderson, Amanda Green, David C. Chang, Nikhil Kansal

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objectives: Open thoracoabdominal aneurysm repair (TAAR) is a rarely performed but a complicated and morbid procedure. This study compares the morbidity and mortality of open TAAR at high- versus low-volume hospitals. Methods: Included patients from California Office of Statewide Health Policy and Development patient discharge database who underwent an open TAAR between 1995 and 2010. High volume was -9 cases per year. Outcomes included mortality and postoperative complications. Multivariate analyses compared patients at high- versus low-volume hospitals. Results: A total of 122 hospitals were included, with 5 designated as high volume. Adjusted analysis found no difference in the odds ratio (OR) of mortality or morbidity at high-volume hospitals compared to low-volume hospitals (OR 0.37, P 1/4 .077; OR 0.94, P 1/4 .834, respectively). However, there was a decreased OR of mortality in high- versus low-volume hospitals when a high-volume hospital was defined as each year after meeting the initial threshold of 9 cases (OR 0.40, P 1/4 .040). Conclusion: We found no difference in mortality between low- and high-volume institutions in California, until high-volume hospitals were defined as each year after meeting initial threshold case volume. This may suggest that the benefits of high-volume hospitals on outcomes are maintained after reaching the requisite case volume.

Original languageEnglish (US)
Pages (from-to)378-382
Number of pages5
JournalVascular and Endovascular Surgery
Volume48
Issue number5-6
DOIs
StatePublished - Jan 1 2014

Keywords

  • thoracoabdominal aneurysm
  • vascular surgery outcomes
  • volume outcomes relationship

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Medicine(all)

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