Surgeon specialty and provider volumes are related to outcome of intact abdominal aortic aneurysm repair in the united states

Dimick, Justin B.; Cowan, John A.; Stanley, James C.; Henke, Peter K.; Pronovost, Peter J.; Upchurch, Gilbert R.

doi:10.1016/s0741-5214(03)00470-1

Cited by 199 publications

(151 citation statements)

References 18 publications

(53 reference statements)

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“…In fact, in a recent analysis, both a high surgeon volume and a high hospital volume were both associated with lower mortality than low-volume providers and that surgeons specializing in vascular surgery had a lower mortality than did nonspecialized surgeons with the same aortic repair volume. 50 A less-invasive alternative to open surgery for repair of abdominal aortic aneurysms is the use of percutaneously implanted, expanding endovascular stent-grafts. Once deployed, the stent-graft serves to bridge the region of the aneurysm, thereby excluding it from the circulation while allowing aortic blood flow to continue distally through the prosthetic stent-graft lumen.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Thoracic and Abdominal Aortic Aneurysms

2005

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Section: Surgical Treatmentmentioning

confidence: 99%

Thoracic and Abdominal Aortic Aneurysms

2005

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“…Studies have shown that high caseloads can lead to better outcomes and lower complication rates in subarachnoid hemorrhage, epilepsy surgery, pediatric brain tumor, and other surgical fields. 3,10,14,16,18,20,41 One would anticipate complication rates to be greater at LVCs across the board, but this has not been proven in the literature. In fact, the complication rate for DBS has remained small even as more LVCs have arisen.…”

Section: Discussionmentioning

confidence: 99%

Predictors of unfavorable outcomes following deep brain stimulation for movement disorders and the effect of hospital case volume on outcomes: an analysis of 33, 642 patients across 234 US hospitals using the National (Nationwide) Inpatient Sample from 2002 to 2011

Kalakoti

Ahmed

Bollam

et al. 2015

FOC

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OBJECT With limited data available on association of risk factors and effect of hospital case volume on outcomes following deep brain stimulation (DBS), the authors attempted to identify these associations using a large population-based database. METHODS The authors performed a retrospective cohort study involving patients who underwent DBS for 3 primary movement disorders: Parkinson’s disease, essential tremor, and dystonia from 2002 to 2011 using the National (Nationwide) Inpatient Sample (NIS) database. Using national estimates, the authors identified associations of patient demographics, clinical characteristics, and hospital characteristics on short-term postoperative outcomes following DBS. Additionally, effect of hospital volume on unfavorable outcomes was investigated. RESULTS Overall, 33, 642 patients underwent DBS for 3 primary movement disorders across 234 hospitals in the US. The mean age of the cohort was 63.42 ± 11.31 years and 36% of patients were female. The inpatients’ postoperative risks were 5.9% for unfavorable discharge, 10.2% for prolonged length of stay, 14.6% for high-end hospital charges, 0.5% for wound complications, 0.4% for cardiac complications, 1.8% for venous thromboembolism, and 5.5% for neurological complications, including those arising from an implanted nervous system device. Compared with low-volume centers, odds of having an unfavorable discharge, prolonged LOS, high-end hospital charges, wound, and cardiac complications were significantly lower in the high-volume and medium-volume centers. CONCLUSIONS The authors’ study provides individualized estimates of the risks of postoperative complications based on patient demographics and comorbidities and hospital characteristics, which could potentially be used as an adjunct for risk stratification for patients undergoing DBS.

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“…2, 9, 10) While certain high-volume centers of excellence report very low mortality rates (from 0% to 1.2%), 3,11,12) multi-institutional nationwide data continue to show significantly higher incidence of mortality ranging between 4.2% and 8.4%. 11,12) This discrepancy has been seen as a result of the case volume related difference in outcome. Many reports have identified a strong relationship between the operative outcome and case volume of the individual surgeon or the institution.…”

Section: Discussionmentioning

confidence: 99%