Editor's Choice – Systematic Review and Meta-Analysis of the Impact of Institutional and Surgeon Procedure Volume on Outcomes After Ruptured Abdominal Aortic Aneurysm Repair

Kontopodis, Nikolaos; Galanakis, Nikolaos; Akoumianakis, Evangelos; Ioannou, Christos; Tsetis, Dimitrios; Antoniou, George Α.

doi:10.1016/j.ejvs.2021.06.015

Cited by 18 publications

(9 citation statements)

References 45 publications

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“…These authors demonstrated also that high-volume surgeons decreased the risk of mortality as well (OR 0.41, 95% CI 0.25–0.66). The findings are similar to those observed after surgery for ruptured abdominal aortic aneurysm, in which hospital volume, but not surgeon’s volume, had a significant impact on perioperative mortality [ 8 ].…”

Section: Discussionsupporting

confidence: 81%

Interinstitutional analysis of the outcome after surgery for type A aortic dissection

Biancari

Gatti

Perrotti

et al. 2023

Eur J Trauma Emerg Surg

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Purpose To evaluate the impact of individual institutions on the outcome after surgery for Stanford type A aortic dissection (TAAD). Methods This is an observational, multicenter, retrospective cohort study including 3902 patients who underwent surgery for TAAD at 18 university and non-university hospitals. Results Logistic regression showed that four hospitals had increased risk of in-hospital mortality, while two hospitals were associated with decreased risk of in-hospital mortality. Risk-adjusted in-hospital mortality rates were lower in four hospitals and higher in other four hospitals compared to the overall in-hospital mortality rate (17.7%). Participating hospitals were classified as overperforming or underperforming if their risk-adjusted in-hospital mortality rate was lower or higher than the in-hospital mortality rate of the overall series, respectively. Propensity score matching yielded 1729 pairs of patients operated at over- or underperforming hospitals. Overperforming hospitals had a significantly lower in-hospital mortality (12.8% vs. 22.2%, p < 0.0001) along with decreased rate of stroke and/or global brain ischemia (16.5% vs. 19.9%, p = 0.009) compared to underperforming hospitals. Aggregate data meta-regression of the results of participating hospitals showed that hospital volume was inversely associated with in-hospital mortality (p = 0.043). Hospitals with an annual volume of less than 15 cases had an increased risk of in-hospital mortality (adjusted OR, 1.345, 95% CI 1.126–1.607). Conclusion The present findings indicate that there are significant differences between hospitals in terms of early outcome after surgery for TAAD. Low hospital volume may be a determinant of poor outcome of TAAD. Trial registration ClinicalTrials.gov Identifier: NCT04831073.

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Section: Discussionsupporting

confidence: 81%

Interinstitutional analysis of the outcome after surgery for type A aortic dissection

Biancari

Gatti

Perrotti

et al. 2023

Eur J Trauma Emerg Surg

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“…In multivariable-adjusted models, patients treated at low-volume centers had a greater mortality risk for open repair (OR, 1.68 [95% CI, 1.21–2.33]) but not endovascular repair (OR, 1.42 [95% CI, 0.84–2.41]). 139 In the United States, data from NIS showed that the risk of death after open thoracoabdominal aortic aneurysm repair in low-volume hospitals was significantly greater than at high-volume hospitals (OR, 1.921 [95% CI, 1.458–2.532]; P <0.001). 140 Racial disparities in perioperative 30-day mortality after TAA repair appear to be present with open (Black people, 18% versus White people, 10%; P <0.001) compared with endovascular (8% versus 9%; P =0.54) approaches on the basis of Medicare data from 1999 to 2007.…”

Section: Peripheral Artery Disease and Aortic Diseasesmentioning

confidence: 99%

Section: Peripheral Artery Disease and Aortic Diseasesmentioning

confidence: 99%

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Tsao¹,

Aday²,

Almarzooq³

et al. 2023

Circulation

3,590

702

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BACKGROUND: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS: The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year’s worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year’s edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS: Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS: The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

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Section: Peripheral Artery Disease and Aortic Diseasesmentioning

confidence: 99%

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

Martin,

Aday,

Almarzooq

et al. 2024

Circulation

476

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BACKGROUND: The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS: The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year’s worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year’s edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS: Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS: The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

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Editor's Choice – Systematic Review and Meta-Analysis of the Impact of Institutional and Surgeon Procedure Volume on Outcomes After Ruptured Abdominal Aortic Aneurysm Repair

Cited by 18 publications

References 45 publications

Interinstitutional analysis of the outcome after surgery for type A aortic dissection

Interinstitutional analysis of the outcome after surgery for type A aortic dissection

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

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