OBJECTIVE: To assess the relationship between the annual caseload of elective open abdominal aortic aneurysm (AAA) repairs performed by individual surgeons and mortality. METHODS: PubMed, EMBASE, and the Cochrane library were searched for articles on the volume-outcome relationship in AAA surgery. The review conformed to the QUOROM statement. The data were meta-analyzed to compare the mortality rates of higher- and lower-volume surgeons. A critical volume threshold was calculated for better practice. RESULTS: Fourteen relevant articles were retrieved from the searches. A systematic review was performed, and six were meta-analyzed. A total of 115,273 elective open AAA repairs were considered, with a mean mortality rate of 5.56%. Significant relationships between higher surgeon caseload and lower mortality were demonstrated in 12 of 14 studies. From the meta-analysis, the pooled effect estimate was an odds ratio of 0.56 (95% confidence interval, 0.54-0.57) in favor of higher-volume surgeons. A critical volume threshold was identified as 13 cases per annum for individual surgeons. CONCLUSIONS: As surgeons performed higher annual volumes of elective open AAA repairs, significantly lower mortality rates were demonstrated. Surgeons wishing to perform elective AAA repairs should achieve a minimum case volume of 13 repairs per annum.
OBJECTIVE: To assess the relationship between the annual caseload of elective open abdominal aortic aneurysm (AAA) repairs performed by individual surgeons and mortality. METHODS: PubMed, EMBASE, and the Cochrane library were searched for articles on the volume-outcome relationship in AAA surgery. The review conformed to the QUOROM statement. The data were meta-analyzed to compare the mortality rates of higher- and lower-volume surgeons. A critical volume threshold was calculated for better practice. RESULTS: Fourteen relevant articles were retrieved from the searches. A systematic review was performed, and six were meta-analyzed. A total of 115,273 elective open AAA repairs were considered, with a mean mortality rate of 5.56%. Significant relationships between higher surgeon caseload and lower mortality were demonstrated in 12 of 14 studies. From the meta-analysis, the pooled effect estimate was an odds ratio of 0.56 (95% confidence interval, 0.54-0.57) in favor of higher-volume surgeons. A critical volume threshold was identified as 13 cases per annum for individual surgeons. CONCLUSIONS: As surgeons performed higher annual volumes of elective open AAA repairs, significantly lower mortality rates were demonstrated. Surgeons wishing to perform elective AAA repairs should achieve a minimum case volume of 13 repairs per annum.
Authors: D A Healy; D P McCartan; P A Grace; A Aziz; F Dermody; M Clarke Moloney; J C Coffey; S R Walsh; P E Burke Journal: Ir J Med Sci Date: 2013-10-04 Impact factor: 1.568
Authors: A Saratzis; A Thatcher; M F Bath; D A Sidloff; M J Bown; J Shakespeare; R D Sayers; C Imray Journal: Ann R Coll Surg Engl Date: 2017-01-10 Impact factor: 1.891
Authors: Bjoern D Suckow; Philip P Goodney; Jesse A Columbo; Ravinder Kang; David H Stone; Art Sedrakyan; Jack L Cronenwett; Mark F Fillinger Journal: J Vasc Surg Date: 2017-12-28 Impact factor: 4.268