Coronary artery bypass grafting. The relationship of surgical volume, hospital location, and outcome.

The relationship between mortality, surgical volume, and location was investigated in the university medical centers (UMCs) in the Greater New York metropolitan area for patients undergoing coronary artery bypass grafting (CABG) in 1986. Three high-volume and five low-volume institutions, with a total of 49 surgeons, performed a total of 3,408 CABG operations. The crude mortality rates were 4% for simple, 14.7% for complex, and 5.3% combined for all UMC CABG operations. The crude mortality rates for CABG operations in high- and low-volume centers were respectively 3.6% and 4.8% for simple and 16.1% and 11.3% for complex operations. No statistically significant differences between urban (N = 6), suburban (N = 2), high-volume (N = 3), or low-volume (N = 5) centers or physicians were found (all p values greater than 0.05). Taken together, these findings suggest that surgical volume and location are not significant factors for predicting outcome for CABG.