Hospital Surgical Volumes and Mortality after Coronary Artery Bypass Grafting: Using International Comparisons to Determine a Safe Threshold.
Health Serv Res
; 52(2): 863-878, 2017 Apr.
Article
em En
| MEDLINE
| ID: mdl-27198068
ABSTRACT
OBJECTIVE:
To estimate a safe minimum hospital volume for hospitals performing coronary artery bypass graft (CABG) surgery. DATA SOURCE Hospital data on all publicly funded CABG in five European countries, 2007-2009 (106,149 patients).DESIGN:
Hierarchical logistic regression models to estimate the relationship between hospital volume and mortality, allowing for case mix. Segmented regression analysis to estimate a threshold.FINDINGS:
The 30-day in-hospital mortality rate was 3.0 percent overall, 5.2 percent (95 percent CI 4.0-6.4) in low-volume hospitals, and 2.1 percent (95 percent CI 1.8-2.3) in high-volume hospitals. There is a significant curvilinear relationship between volume and mortality, flatter above 415 cases per hospital per year.CONCLUSIONS:
There is a clear relationship between hospital CABG volume and mortality in Europe, implying a "safe" threshold volume of 415 cases per year.Palavras-chave
Texto completo:
1
Temas:
ECOS
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Aspectos_gerais
Bases de dados:
MEDLINE
Assunto principal:
Centro Cirúrgico Hospitalar
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Ponte de Artéria Coronária
Tipo de estudo:
Prognostic_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Health Serv Res
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Reino Unido