Literature DB >> 27198068

Hospital Surgical Volumes and Mortality after Coronary Artery Bypass Grafting: Using International Comparisons to Determine a Safe Threshold.

Nils Gutacker1, Karen Bloor2, Richard Cookson1, Chris P Gale3, Alan Maynard2, Domenico Pagano4, José Pomar5, Enrique Bernal-Delgado6.   

Abstract

OBJECTIVE: To estimate a safe minimum hospital volume for hospitals performing coronary artery bypass graft (CABG) surgery. DATA SOURCE: Hospital data on all publicly funded CABG in five European countries, 2007-2009 (106,149 patients).
DESIGN: Hierarchical logistic regression models to estimate the relationship between hospital volume and mortality, allowing for case mix. Segmented regression analysis to estimate a threshold.
FINDINGS: The 30-day in-hospital mortality rate was 3.0 percent overall, 5.2 percent (95 percent CI: 4.0-6.4) in low-volume hospitals, and 2.1 percent (95 percent CI: 1.8-2.3) in high-volume hospitals. There is a significant curvilinear relationship between volume and mortality, flatter above 415 cases per hospital per year.
CONCLUSIONS: There is a clear relationship between hospital CABG volume and mortality in Europe, implying a "safe" threshold volume of 415 cases per year. © Health Research and Educational Trust.

Entities:  

Keywords:  Coronary artery bypass surgery; center-volume; international comparisons; mortality

Mesh：

Year:  2016        PMID： 27198068      PMCID： PMC5346497          DOI： 10.1111/1475-6773.12508

Source DB:  PubMed          Journal:  Health Serv Res        ISSN： 0017-9124            Impact factor:   3.402


  27 in total

1.  Trends in hospital volume and operative mortality for high-risk surgery.

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3.  PCI or CABG in coronary artery disease?

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5.  The American Heart Association's recommendations for expanding the applications of existing and future clinical registries: a policy statement from the American Heart Association.

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Journal:  Circulation       Date:  2011-04-11       Impact factor: 29.690

6.  Volume and outcome in coronary artery bypass graft surgery: true association or artefact?

Authors:  A J Sowden; J J Deeks; T A Sheldon
Journal:  BMJ       Date:  1995-07-15

7.  ECHO: health care performance assessment in several European health systems.

Authors:  E Bernal-Delgado; T Christiansen; K Bloor; C Mateus; A M Yazbeck; J Munck; J Bremner
Journal:  Eur J Public Health       Date:  2015-02       Impact factor: 3.367

8.  Procedural volume as a marker of quality for CABG surgery.

Authors:  Eric D Peterson; Laura P Coombs; Elizabeth R DeLong; Constance K Haan; T Bruce Ferguson
Journal:  JAMA       Date:  2004-01-14       Impact factor: 56.272

9.  Comparing the performance of the Charlson/Deyo and Elixhauser comorbidity measures across five European countries and three conditions.

Authors:  Nils Gutacker; Karen Bloor; Richard Cookson
Journal:  Eur J Public Health       Date:  2015-02       Impact factor: 3.367

10.  Comparing hospital performance within and across countries: an illustrative study of coronary artery bypass graft surgery in England and Spain.

Authors:  Nils Gutacker; Karen Bloor; Richard Cookson; Sandra Garcia-Armesto; Enrique Bernal-Delgado
Journal:  Eur J Public Health       Date:  2015-02       Impact factor: 3.367
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  8 in total

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2.  Monitoring the Impact of Aggressive Glycemic Intervention during Critical Care after Cardiac Surgery with a Glycemic Expert System for Nurse-Implemented Euglycemia: The MAGIC GENIE Project.

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4.  Retrospective cohort analysis of Spanish national trends of coronary artery bypass grafting and percutaneous coronary intervention from 1998 to 2017.

Authors:  Manuel Carnero Alcazar; Daniel Hernandez-Vaquero; Hector Cubero-Gallego; Jose Lopez Menendez; Miguel Piñon; Jose Albors Martin; Gregorio Cuerpo Caballero; Javier Cobiella Carnicer; Cristina Villamor; Alberto Forteza; Isaac Pascual; Luis Carlos Maroto Castellanos
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5.  Optimal surgeon and hospital volume thresholds to reduce mortality and length of stay for CABG.

Authors:  Ying-Yi Chou; Juey-Jen Hwang; Yu-Chi Tung
Journal:  PLoS One       Date:  2021-04-14       Impact factor: 3.240

6.  Improvements in Dental Health and Dentists' Workload in Norway, 1992 to 2015.

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7.  Hospital volume and mortality for 25 types of inpatient treatment in German hospitals: observational study using complete national data from 2009 to 2014.

Authors:  Ulrike Nimptsch; Thomas Mansky
Journal:  BMJ Open       Date:  2017-09-06       Impact factor: 2.692

8.  Cross-national health care database utilization between Spain and France: results from the EPICHRONIC study assessing the prevalence of type 2 diabetes mellitus.

Authors:  Guillaume Moulis; Berta Ibañez; Aurore Palmaro; Felipe Aizpuru; Eduardo Millan; Maryse Lapeyre-Mestre; Laurent Sailler; Koldo Cambra
Journal:  Clin Epidemiol       Date:  2018-07-27       Impact factor: 4.790
  8 in total

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