Center surgical volume linked to LVAD patient outcomes

September 8, 2017

(HealthDay)—Center surgical volume is associated with left ventricular assist device (LVAD) patient outcomes, with worse survival at very-low-volume centers, according to a study published online Sept. 6 in JACC: Heart Failure.

Jennifer A. Cowger, M.D., from Henry Ford Medical Center in Detroit, and colleagues examined the impact of center LVAD surgical volumes on . Data on center volume were available for 7,416 ; volume was categorized as very low (≤10 implants/year; 617 patients), low (11 to 30 implants/year; 2,561 patients), medium (31 to 50 implants/year; 2,458 patients), and high (>50 implants/year; 1,750 patients).

The researchers found that there was a correlation between overall survival and center volume (71±1.8, 81±0.8, 83±0.8, and 79±1 percent at very-low-, low-, medium-, and high-volume centers at one year; P = 0.003). The 90-day mortality was higher in very-low-volume and high-volume centers compared with medium-volume centers (odds ratio, 1.35 [P = 0.04] and 1.28 [P = 0.018]). For very-low, low-, and high-volume centers, the adjusted hazard ratio for mortality was 1.32 [95 percent confidence interval, 1.11 to 1.56), 1.07 (95 percent confidence interval, 0.95 to 1.21), and 1.17 (95 percent confidence interval, 1.03 to 1.3), respectively.

"Center volume correlates with post-VAD survival, with worse survival noted at very-low-volume centers," the authors write.

Several authors disclosed financial ties to the pharmaceutical and medical device industries.

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