The Relationship Between Volume and Outcome Following Elective Open Repair of Abdominal Aortic Aneurysms (AAA) in 131 German Hospitals

Eckstein, H.‐H.; Bruckner, Tom; Heider, P.; Wolf, Oliver T.; Hanke, Martin; Niedermeier, H.; Noppeney, T.; Umscheid, Thomas; Wenk, H.

doi:10.1016/j.ejvs.2007.05.006

Cited by 65 publications

(23 citation statements)

References 23 publications

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“…only one study (17) had the explicit aim of searching for the best thresholdvalue to separate volume-mortality groups. Most of the studies demonstrated as ignificant inverse volume-mortality relationship but the heterogeneity of study design makes it difficult to pool results.…”

Section: Resultsmentioning

confidence: 99%

“…Seventeen other papers (model studies, studies on the effect of surgeon volume or specialization and others) werealso excluded. Thus 15 papers weret he base of the present study.T welve papers originated in north America (USA , Canada (15,16)) and three in Europe (UK (15,16),Germany (17)). reference lists provided one morerelevant US article (12).…”

Section: Method Materialsmentioning

confidence: 99%

See 1 more Smart Citation

Volume versus Outcome When Treating Abdominal Aortic Aneurysm Electively — Is There Evidence to Centralise?

Troëng

2008

Scand J Surg

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Section: Resultsmentioning

confidence: 99%

Section: Method Materialsmentioning

confidence: 99%

Volume versus Outcome When Treating Abdominal Aortic Aneurysm Electively — Is There Evidence to Centralise?

Troëng

2008

Scand J Surg

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“…In reverse, a meta-analysis considering 115,273 elective open AAA repairs mentioned a mean mortality rate of 5.56 %, with a significant relationship between higher surgeon caseload and lower mortality (E.L. Young et al, 2007). After all, the German national registry comprising 10,163 elective open repairs of AAA performed in 131 hospitals reported an overall perioperative mortality rate of 3.2% (Eckstein et al, 2007).…”

Section: Perioperative Mortality After Endovascular and Open Repair Omentioning

confidence: 99%

The Abdominal Aortic Aneurysm – Prognosis, Treatment, Screening and Cost-Effectiveness

Grundmann¹

2011

Diagnosis, Screening and Treatment of Abdominal, Thoracoabdominal and Thoracic Aortic Aneurysms

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Prevalence of abdominal aortic aneurysm and mortality rateGenerally, an AAA is considered to be present when the minimum anterioposterior diameter of the aorta reaches 3.0 cm (Hirsch et al., 2006). The prevalence of AAA depends on various risk factors, as advancing age, family history, male gender, and tobacco use. According to the ACC/AHA guidelines (Hirsch et al., 2006) the prevalence of AAA 2.9 to 4.9 cm in diameter ranges from 1.3 % for men aged 45 to 54 years up to 12.5 % for men 75 to 84 years of age. Comparable prevalence figures for women are 0% and 5.2 %, respectively. Scott et al., 1995 reported in men and women aged 65-80 years a prevalence rate of 4 % overall and 7.6 % of men. Vardulaki et al., 1999 observed in two different areas the prevalence of AAA ranging between 5.3 % and 8% and between 6.18% and 9.88 %, respectively, in men aged between 65 and 79 years. In the Multicentre Aneurysm Screening Study (MASS) the prevalence in men aged 65-74 years was 4.9% (Ashton et al., 2002). In these studies the AAA was defined as an aortic diameter  3cm. If clinically important aneurysms are only taken into account (AAA www.intechopen.com Diagnosis, Screening and Treatment of Abdominal, Thoracoabdominal and Thoracic Aortic Aneurysms 2 measuring  4 cm in diameter) the indicated prevalence would be lower. Van Walraven et al., 2010 identified the prevalence of incidental AAA during imaging for other reasons. In 79,121 abdominal images 812 incidental AAA with a mean diameter of 4.0 cm (1% of all studies) were detected in patients with a mean age of 74 years. Lederle et al., 1997 reported the results of ultrasonography screening for AAA in 73,451 US veterans who were 50 to 79 years of age and had no history of AAA. The infrarenal aortic diameter was at least 4 cm in 1031 patients (1.4%), 368 patients (0.5%) had an AAA of 5 cm or larger. Smoking was the factor most closely associated with AAA in this study. In men who never smoked the prevalence of AAA 4 cm or larger was 0 % (patient age 50 to 59 years) and 0.8% (patient age > 75 years), respectively. The corresponding figures for men who smoked were 0.9 % and 2.7 %, respectively. A second cohort study of the Department of Veterans Affairs medical centers (Lederle et al., 2000) including 52,745 subjects aged 50 to 79 years confirmed the findings previously reported and supported the hypothesis that AAA is primarily a smoking-related disease. In this study AAA of 4.0 cm or larger were detected in 613 participants (1.2%). The excess prevalence associated with smoking accounted for approximately 75% of all AAA of 4.0 cm or larger. Smoking as a very strong risk factor for AAA was also proven by the Tromsø study (Forsdahl et al., 2009). When subjects who reported to have never been a daily smoker were compared with those who currently were smoking 20 cigarettes or more, the latter group had a > 13 times increased risk of an incident AAA during follow-up. In the women`s health initiative, an observational study involving 161,808 postmenopausal women, too, a strong positi...

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“…Recent publications distinguish between patients with an open and an endovascular aneurysm repair (EVAR) (Dimick and Upchurch, 2008;Holt et al, 2009;Landon et al, 2010;McPhee et al, 2011). So far, evidence for Germany is lacking with only one study from Eckstein et al (2007). They used clinical data from the Hip fracture is less frequently evaluated in volume-outcome studies.…”

Section: Introductionmentioning

confidence: 99%

“…The authors used data from 1993 to 1998 with a total of 26,005 patients and found significant differences in mortality rates between patients treated in hospitals with the lowest case volume and patients treated in hospitals with the highest case volume. But like Eckstein et al (2007) the cluster structure of the data was not considered and no further hospital characteristics were added to the regression analysis.…”

Section: Introductionmentioning

confidence: 99%

The Relationship between Quality and Hospital Case Volume – An Empirical Examination with German Data

Hentschker

Mennicken

2012

SSRN Journal

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. The working papers published in the Series constitute work in progress circulated to stimulate discussion and critical comments. Views expressed represent exclusively the authors' own opinions and do not necessarily refl ect those of the editors. Terms of use: Documents in Ruhr Economic Papers #341

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The Relationship Between Volume and Outcome Following Elective Open Repair of Abdominal Aortic Aneurysms (AAA) in 131 German Hospitals

Cited by 65 publications

References 23 publications

Volume versus Outcome When Treating Abdominal Aortic Aneurysm Electively — Is There Evidence to Centralise?

Volume versus Outcome When Treating Abdominal Aortic Aneurysm Electively — Is There Evidence to Centralise?

The Abdominal Aortic Aneurysm – Prognosis, Treatment, Screening and Cost-Effectiveness

The Relationship between Quality and Hospital Case Volume – An Empirical Examination with German Data

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