Cumulative risk adjusted monitoring of 30-day mortality after cardiothoracic transplantation: UK experience

Rogers, Chris; Ganesh, J. Saravana; Banner, Nicholas R.; Bonser, Robert S.

doi:10.1016/j.ejcts.2005.02.033

Cited by 33 publications

(25 citation statements)

References 23 publications

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“…Because lowvolume centers are expected to have a large variation in annual mortality rates, simply through sampling variation, statistical process control techniques such as cumulative sum charts are required to monitor performance. 25,26 There are no international guidelines regarding acceptable volumes for heart transplant centers. In the United States, Centers for Medicare and Medicaid Services require heart transplant centers to perform at least 10 transplants per year and centers are defined as functionally inactive if no transplants are performed for 3 months.…”

Section: Can Low-volume Transplant Centers Have Satisfactory Outcomes?mentioning

confidence: 99%

How Small Is Too Small? A Systematic Review of Center Volume and Outcome After Cardiac Transplantation

Pettit

Jhund²,

Hawkins³

et al. 2012

Circ: Cardiovascular Quality and Outcomes

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Background-The aim of this study was to assess the relationship between the volume of cardiac transplantation procedures performed in a center and the outcome after cardiac transplantation. Methods and Results-PubMed, Embase, and the Cochrane library were searched for articles on the volume-outcome relationship in cardiac transplantation. Ten studies were identified, and all adopted a different approach to data analysis and varied in adjustment for baseline characteristics. The number of patients in each study ranged from 798 to 14 401, and observed 1-year mortality ranged from 12.6% to 34%. There was no association between the continuous variables of center volume and observed mortality. There was a weak association between the continuous variables of center volume and adjusted mortality up to 1 year and a stronger association at 5 years. When centers were grouped in volume categories, low-volume centers had the highest adjusted mortality, intermediate-volume centers had lower adjusted mortality, and high-volume centers had the lowest adjusted mortality but were not significantly better than intermediate-volume centers. Category limits were arbitrary and varied between studies. Conclusions-There is a relationship between center volume and mortality in heart transplantation. The existence of a minimum acceptable center volume or threshold is unproven. However, a level of 10 to 12 heart transplants per year corresponds to the upper limit of low-volume categories that may have relatively higher mortality. It is not known whether outcomes for patients treated in low-volume transplant centers would be improved by reorganizing centers to ensure volumes in excess of 10 to 12 heart transplants per year. (Circ Cardiovasc Qual Outcomes. 2012;5:783-790.)

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Section: Can Low-volume Transplant Centers Have Satisfactory Outcomes?mentioning

confidence: 99%

How Small Is Too Small? A Systematic Review of Center Volume and Outcome After Cardiac Transplantation

Pettit

Jhund²,

Hawkins³

et al. 2012

Circ: Cardiovascular Quality and Outcomes

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show abstract

“…We did not find the donor NT-proBNP levels to be higher in those hearts exhibiting a degree of PGD in the recipient, which is, perhaps, not surprising as the NTproBNP levels in the donors, whose hearts were actually transplanted, were in the lower range within the cohort as a whole. Moreover, the small sample size did not allow adjustment for known risk factors for PGD, including donor age and ischaemic time and a number of other recipient characteristics [24]. Nevertheless, larger studies may identify individual biomarkers as risk factors for PGD as has been partly shown for troponins [25], procalcitonin [19] and tumour necrosis factor-a [21].…”

Section: Discussionmentioning

confidence: 96%

N-terminal pro-brain-type natriuretic peptide: a biochemical surrogate of cardiac function in the potential heart donor☆☆☆

Dronavalli

Ranasinghe

Venkateswaran

et al. 2010

European Journal of Cardio-Thoracic Surgery

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“…The utility of the CUmulative SUM (CUSUM) chart in monitoring surgical outcomes has been shown in various specialties [5][6][7][8][9][10][11][12][13][14][15][16][17]. The CUSUM chart is cumulatively updated after each patient and is designed to detect deviation of an outcome rate from that expected as quickly as possible, while keeping the number of false alarms at an acceptable level [8].…”

Section: Introductionmentioning

confidence: 99%

Continuous monitoring tools for pediatric surgical outcomes: an example using biliary atresia

Sibanda

Lewsey

Meulen

et al. 2007

Journal of Pediatric Surgery

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Cumulative risk adjusted monitoring of 30-day mortality after cardiothoracic transplantation: UK experience

Cited by 33 publications

References 23 publications

How Small Is Too Small? A Systematic Review of Center Volume and Outcome After Cardiac Transplantation

How Small Is Too Small? A Systematic Review of Center Volume and Outcome After Cardiac Transplantation

N-terminal pro-brain-type natriuretic peptide: a biochemical surrogate of cardiac function in the potential heart donor☆☆☆

Continuous monitoring tools for pediatric surgical outcomes: an example using biliary atresia

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