Institutional case volume and mortality after aortic and mitral valve replacement: a nationwide study in two Korean cohorts
Rattachement africain : kr, Éthiopie. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: There are only a handful of published studies regarding the volume-outcome relationship in heart valve surgery. We evaluated the association between institutional case volume and mortality after aortic valve replacement (AVR) and mitral valve replacement (MVR). METHODS: Two separate cohorts of all adults who underwent AVR or MVR, respectively, between 2009 and 2016 were analyzed using a Korean healthcare insurance database. Hospitals performing AVRs were divided into three groups according to the average annual case volume: the low- (< 20 cases/year), medium- (20-70 cases/year), and high-volume centers (> 70 cases/year). Hospitals performing MVRs were also grouped as the low- (< 15 cases/year), medium- (15-40 cases/year), or high-volume centers (> 40 cases/year). In-hospital mortality after AVR or MVR were compared among the groups. RESULTS: In total, 7875 AVR and 5084 MVR cases were analyzed. In-hospital mortality after AVR was 8.3% (192/2318), 4.0% (84/2102), and 2.6% (90/3455) in the low-, medium-, and high-volume centers, respectively. The adjusted risk was higher in the low- (OR 2.31, 95% CI 1.73-3.09) and medium-volume centers (OR 1.53, 95% CI 1.09-2.15) compared to the high-volume centers. In-hospital mortality after MVR was 9.3% (155/1663), 6.3% (94/1501), and 2.9% (56/1920) in the low-, medium-, and high-volume centers, respectively. Compared to the high-volume centers, the medium- (OR 1.97, 95% CI 1.35-2.88) and low-volume centers (OR 2.29, 95% CI 1.60-3.27) showed higher adjusted risk of in-hospital mortality. CONCLUSIONS: Lower case volume is associated with increased in-hospital mortality after AVR and MVR. The results warrant a comprehensive discussion regarding regionalization/centralization of cardiac valve replacements to optimize patient outcomes.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Institutional case volume and mortality after aortic and mitral valve replacement: a nationwide study in two Korean cohorts
- Date Crossref
- 20/08/2022
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Seoul National University Hospital Department of Anesthesiology and Pain Medicine pays non établi dans la noticeÉtablissement de santé
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Gyeongguk National University pays non établi dans la noticeUniversité ou école supérieure
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Kyungpook National University Department of Statistics pays non établi dans la noticeUniversité ou école supérieure
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New Generation University College Éthiopie (code pays fourni par la source)Université ou école supérieure
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Andong National University Department of Information Statistics pays non établi dans la noticeUniversité ou école supérieure
Department of Anesthesiology and Pain Medicine — Seoul National University Hospital, Gyeongguk National University et Department of Statistics — Kyungpook National University, avec 2 autres affiliations. Pays d’affiliation : Éthiopie.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.