Center surgical volume linked to LVAD patient outcomes

(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 patient outcomes. Data on center volume were available for 7,416 patients; 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.