Hospital Volume and Outcomes after Elective Abdominal Aortic Aneurysm Repair: A Systematic Review and Dose-Response Meta-Analysis.
Mayara Leite Coutinho, Lucas Monteiro Delgado, Mario D'Oria et al.
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In 30 seconds
This systematic review and dose-response meta-analysis examined the relationship between hospital and surgeon procedural volume and outcomes after elective abdominal aortic aneurysm (AAA) repair. Analyzing 11 observational studies, it found that higher hospital procedural volume is significantly associated with lower overall mortality, with hospitals at the 90th percentile having 35% lower odds of mortality compared to those at the 10th percentile (odds ratio: 0.65).
Key findings
- Higher hospital procedural volume is associated with lower overall mortality after elective AAA repair (β = -0.0102, P = 0.011).
- Hospitals at the 90th percentile of procedural volume had 35% lower odds of mortality compared to those at the 10th percentile (odds ratio: 0.65).
- A significant inverse association was found between hospital volume and failure-to-rescue after open repair (β = -0.0407, P = 0.0006).
Why it matters
Understanding the volume-outcome relationship in AAA repair can guide clinicians in making informed decisions about patient referrals and institutional practices, potentially improving patient outcomes through centralized care in higher-volume centers.