Relation between Hospital Volume and Outcome of Elective Surgery for Abdominal Aortic Aneurysm: A Systematic Review

Abstract

We found some evidence for a relation between the volume of AAA surgery and peri-operative mortality. There seems to be a nonsignificant trend in favour of high volume hospitals. However we could not derive an unequivocal volume threshold for safely performing AAA surgery.

Hospital volume of percutaneous radiofrequency ablation is closely associated with treatment outcomes for patients with hepatocellular carcinoma

“…[4][5][6] Previous studies based on high-risk procedures have discovered that operative or in-hospital mortality rates are lower in high-volume hospitals. [10][11][12][13][14][15][16][17][18] The differences for post-RFA morbidity and mortality between high-volume and low-volume hospitals may be limited because of the low complication rates attributable to RFA. The influence of hospital volume on late survival cannot be fully explained using differences in post-RFA morbidity and mortality and should be attributed to other factors.…”

“…7,8 The relation between tumor volume and outcome has been widely discussed in past decades, and previous studies have verified this relation in various procedures. [9][10][11] For procedures that depend greatly on technique, such as cancer surgery (including hepatectomy for HCC), hospital volume not only has been associated with decreased treatment-related mortality and complication rates, [12][13][14][15][16][17][18] it also has been associated with better long-term survival rates. [19][20][21][22][23][24][25][26] A successful percutaneous RFA for HCC relies heavily on physician technique, because the procedure requires the insertion of a needle electrode directly into the lesion using imaging guidance (ultrasound or computed tomography).…”

Statistical modeling of the volume-outcome effect for carotid endarterectomy for 10 years of a statewide database

“…Studies of other surgically treated diseases support the notion that "practice makes perfect": those surgeons or hospitals performing the greatest number of surgeries yearly provide the best outcomes. [6][7][8][9][10][11][12][13][14][15][16][17] Numerous studies of CEA have established tiers of surgeons or hospitals performing low-, middle-, and high-numbers of CEAs per year and demonstrated differences in outcomes among these strata. 15,[18][19][20][21][22][23][24] Using this evidence, practitioners and health policymakers have argued that higher volume surgeons and hospitals render superior CEA results to patients, leading to calls for regionalization of CEA care.…”

Hospital Volume and Operative Mortality in the Modern Era

“…Over the last ten years, a large body of literature supporting the presence of a hospital volume-outcome relationship, including numerous systematic reviews, [18][19][20][21][22][23][24][25] has been developed. An early definitive systematic review on the subject was performed by Halm and colleagues and reported a significant association across a wide range of procedures and conditions.…”