Higher acute aortic dissection risk with lower-volume care

Higher acute aortic dissection risk with lower-volume care
The mortality risk from emergency repair of acute aortic dissection is double when performed by lower-volume providers, according to research published in the May issue of the Annals of Thoracic Surgery.

(HealthDay)—The mortality risk from emergency repair of acute aortic dissection is double when performed by lower-volume providers, according to research published in the May issue of the Annals of Thoracic Surgery.

Joanna Chikwe, M.D., from the Mount Sinai Medical Center in New York City, and colleagues analyzed outcomes data from the Nationwide Inpatient Sample (2003 to 2008) on 5,184 patients (mean age, 60.3 years; 65.9 percent male) diagnosed with acute aortic dissection.

The researchers found that with similar preoperative patient risk profiles across institutions and individual surgeons the overall was 21.6 percent. There was a significant, inverse relationship between operative mortality and both institution and surgeon volume. Specifically, surgeons who averaged less than one aortic dissection repair annually had a mean operative mortality of 27.5 percent, compared with 17.0 percent for those averaging five or more annually (odds ratio, 1.78). Similar findings were seen with institutional volume and mortality. Operative mortality was 27.4 percent in institutions performing three or fewer acute aortic dissections a year, compared with 16.4 percent in those performing more than 13 annually. Operative mortality decreased steadily nationally, from 23 percent in 1998 to 2000 to 19 percent in 2005 to 2008, with no significant change in patient risk profile.

"Patients undergoing emergency repair of by lower-volume surgeons and centers have approximately double the risk-adjusted mortality of patients undergoing repair by the highest volume care providers," the authors write.

Two authors disclosed to Edwards Lifesciences and/or Medtronic.

More information: Abstract
Full Text (subscription or payment may be required)

Related Stories

Recommended for you

Cognitive impairment predicts worse outcome in heart failure

date May 24, 2015

Cognitive impairment predicts worse outcome in elderly heart failure patients, reveals research presented today at Heart Failure 2015 by Hiroshi Saito, a physiotherapist at Kameda Medical Centre in Kamogawa, Japan. Patients ...

1950s drug is future heart treatment

date May 22, 2015

Oxford University researchers have found a promising future treatment for heart disease, going back to a drug first developed in 1950.

Time is muscle in acute heart failure

date May 21, 2015

Urgent diagnosis and treatment in acute heart failure has been emphasised for the first time in joint recommendations published today in European Heart Journal.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.