TY - JOUR
T1 - Surgeon elective abdominal aortic aneurysm repair volume and outcomes of ruptured abdominal aortic aneurysm repair
T2 - A 12-year nationwide study
AU - Chen, Chun Ku
AU - Chang, Hsiao Ting
AU - Chen, Yu Chun
AU - Chen, Tzeng Ji
AU - Chen, I. Ming
AU - Shih, Chun Che
N1 - Funding Information:
This work was supported by The National Science Council, Taiwan (NSC98-2314-B-010-035-MY3, 101-2314-B-065-MY3) and the Taipei Veterans General Hospital, Taiwan (V100C-018, V101-C-162). The study is based, in part, on data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health and managed by the National Health Research Institutes in Taiwan. The interpretation and conclusions contained herein do not represent those of the Bureau of National Health Insurance, Department of Health, or the National Health Research Institutes. The authors are grateful to Sih-Chih Chang for the summary of the operation of the emergency medical system.
PY - 2013/10/1
Y1 - 2013/10/1
N2 - Background: The purpose of the present study was to examine the effects of surgeon elective abdominal aortic aneurysm repair volume on outcomes after ruptured abdominal aortic aneurysm (rAAA) repair. Methods: A nationwide claims database was used to identify patients who underwent rAAA repair from 1998 to 2009. Surgeon elective open abdominal aortic aneurysm repair (EAR) volume was classified as low, medium, or high. Associations between surgeon EAR volume and in-hospital mortality, overall survival, and complications after open rAAA repair (RAR) were compared with multivariate analysis. Associations between surgeon elective endovascular abdominal aortic aneurysm repair (EER) volume and outcomes after endovascular rAAA repair (RER) were also analyzed. Results: A total of 537 patients who underwent rAAA repair were identified, including 498 who underwent RAR and 39 who underwent RER. In-hospital mortality rates after RAR were 49, 38, and 24 % in the low, medium, and high EAR volume groups, respectively (p < 0.001). Patients in the low surgeon EAR volume group had higher in-hospital mortality than those in the high surgeon EAR volume group [odds ratio 3.39, 95 % confidence interval (CI) 1.52, 7.59; p = 0.003]. Patients in the low surgeon EAR volume group also had higher long-term mortality (hazard ratio 1.86, 95 % CI 1.21, 2.85; p = 0.005). There were no significant differences in complication rates among the surgeon EAR volume groups or in-hospital mortality after RER among the surgeon EER volume groups. Conclusions: Surgeon EAR volume is associated with in-hospital mortality and long-term survival after RAR.
AB - Background: The purpose of the present study was to examine the effects of surgeon elective abdominal aortic aneurysm repair volume on outcomes after ruptured abdominal aortic aneurysm (rAAA) repair. Methods: A nationwide claims database was used to identify patients who underwent rAAA repair from 1998 to 2009. Surgeon elective open abdominal aortic aneurysm repair (EAR) volume was classified as low, medium, or high. Associations between surgeon EAR volume and in-hospital mortality, overall survival, and complications after open rAAA repair (RAR) were compared with multivariate analysis. Associations between surgeon elective endovascular abdominal aortic aneurysm repair (EER) volume and outcomes after endovascular rAAA repair (RER) were also analyzed. Results: A total of 537 patients who underwent rAAA repair were identified, including 498 who underwent RAR and 39 who underwent RER. In-hospital mortality rates after RAR were 49, 38, and 24 % in the low, medium, and high EAR volume groups, respectively (p < 0.001). Patients in the low surgeon EAR volume group had higher in-hospital mortality than those in the high surgeon EAR volume group [odds ratio 3.39, 95 % confidence interval (CI) 1.52, 7.59; p = 0.003]. Patients in the low surgeon EAR volume group also had higher long-term mortality (hazard ratio 1.86, 95 % CI 1.21, 2.85; p = 0.005). There were no significant differences in complication rates among the surgeon EAR volume groups or in-hospital mortality after RER among the surgeon EER volume groups. Conclusions: Surgeon EAR volume is associated with in-hospital mortality and long-term survival after RAR.
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U2 - 10.1007/s00268-013-2136-0
DO - 10.1007/s00268-013-2136-0
M3 - Article
C2 - 23860878
AN - SCOPUS:84883556408
SN - 0364-2313
VL - 37
SP - 2360
EP - 2371
JO - World Journal of Surgery
JF - World Journal of Surgery
IS - 10
ER -