Higher acute aortic dissection risk with lower-volume care

May 13, 2013
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.

Explore further: Mortality for acute aortic dissection near one percent per hour during initial onset

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

Related Stories

Mortality for acute aortic dissection near one percent per hour during initial onset

March 10, 2013
The belief among medical professionals in the 1950s that the mortality rate for type A acute aortic dissection during the initial 24 hours was one to two percent per hour appears to hold true in the contemporary era of treatment, ...

In-hospital mortality no different at critical access hospitals

May 5, 2013
(HealthDay)—For eight inpatient surgical procedures, mortality is similar at critical access hospitals (CAHs) and non-CAHs, but costs are higher at CAHs, according to a study published online May 1 in JAMA Surgery.

Hospital volume and surgeon specialty influence patient outcomes

June 15, 2012
Researchers from the Netherlands Cancer Institute wanted to understand if patients undergoing lung cancer resections would benefit from having their procedures performed in a high-volume specialized center. The study, published ...

Post-op mortality up for elderly with pre-heart op anxiety

January 11, 2013
(HealthDay)—Few elderly patients about to undergo cardiac surgery experience high levels of anxiety, but for those who do, there is a five-fold higher risk of postoperative major morbidity or mortality, according to research ...

Increases in mean platelet volume after PCI tied to death

January 25, 2013
(HealthDay)—For patients who undergo percutaneous coronary intervention (PCI), mortality is associated with increases in mean platelet volume (MPV) over time following the procedure, according to a study published in the ...

Recommended for you

Could aggressive blood pressure treatments lead to kidney damage?

July 18, 2017
Aggressive combination treatments for high blood pressure that are intended to protect the kidneys may actually be damaging the organs, new research from the University of Virginia School of Medicine suggests.

Quantifying effectiveness of treatment for irregular heartbeat

July 17, 2017
In a small proof-of-concept study, researchers at Johns Hopkins report a complex mathematical method to measure electrical communications within the heart can successfully predict the effectiveness of catheter ablation, the ...

Concerns over side effects of statins stopping stroke survivors taking medication

July 17, 2017
Negative media coverage of the side effects associated with taking statins, and patients' own experiences of taking the drugs, are among the reasons cited by stroke survivors and their carers for stopping taking potentially ...

Study discovers anticoagulant drugs are being prescribed against safety advice

July 17, 2017
A study by researchers at the University of Birmingham has shown that GPs are prescribing anticoagulants to patients with an irregular heartbeat against official safety advice.

Protein may protect against heart attack

July 14, 2017
DDK3 could be used as a new therapy to stop the build-up of fatty material inside the arteries

Heart study finds faulty link between biomarkers and clinical outcomes

July 14, 2017
Surrogate endpoints (biomarkers), which are routinely used in clinical research to test new drugs, should not be trusted as the ultimate measure to approve new health interventions in cardiovascular medicine, according to ...

0 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.