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Interinstitutional analysis of the outcome after surgery for type A aortic dissection
F. Biancari, AM. Dell'Aquila, G. Gatti, A. Perrotti, A. Hervé, J. Touma, M. Pettinari, S. Peterss, J. Buech, K. Wisniewski, T. Juvonen, M. Jormalainen, C. Mustonen, A. Rukosujew, T. Demal, L. Conradi, M. Pol, P. Kacer, F. Onorati, C. Rossetti, I....
Jazyk angličtina Země Německo
Typ dokumentu pozorovací studie, multicentrická studie, časopisecké články
NLK
ProQuest Central
od 2007-02-01 do Před 1 rokem
CINAHL Plus with Full Text (EBSCOhost)
od 2007-02-01 do Před 1 rokem
Nursing & Allied Health Database (ProQuest)
od 2007-02-01 do Před 1 rokem
Health & Medicine (ProQuest)
od 2007-02-01 do Před 1 rokem
- MeSH
- disekce aorty * chirurgie MeSH
- lidé MeSH
- mortalita v nemocnicích MeSH
- nemocnice MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
PURPOSE: To evaluate the impact of individual institutions on the outcome after surgery for Stanford type A aortic dissection (TAAD). METHODS: This is an observational, multicenter, retrospective cohort study including 3902 patients who underwent surgery for TAAD at 18 university and non-university hospitals. RESULTS: Logistic regression showed that four hospitals had increased risk of in-hospital mortality, while two hospitals were associated with decreased risk of in-hospital mortality. Risk-adjusted in-hospital mortality rates were lower in four hospitals and higher in other four hospitals compared to the overall in-hospital mortality rate (17.7%). Participating hospitals were classified as overperforming or underperforming if their risk-adjusted in-hospital mortality rate was lower or higher than the in-hospital mortality rate of the overall series, respectively. Propensity score matching yielded 1729 pairs of patients operated at over- or underperforming hospitals. Overperforming hospitals had a significantly lower in-hospital mortality (12.8% vs. 22.2%, p < 0.0001) along with decreased rate of stroke and/or global brain ischemia (16.5% vs. 19.9%, p = 0.009) compared to underperforming hospitals. Aggregate data meta-regression of the results of participating hospitals showed that hospital volume was inversely associated with in-hospital mortality (p = 0.043). Hospitals with an annual volume of less than 15 cases had an increased risk of in-hospital mortality (adjusted OR, 1.345, 95% CI 1.126-1.607). CONCLUSION: The present findings indicate that there are significant differences between hospitals in terms of early outcome after surgery for TAAD. Low hospital volume may be a determinant of poor outcome of TAAD. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04831073.
Anesthesia and Critical Care Research Unit of Surgery University of Oulu Oulu Finland
Cardiac Surgery Molinette Hospital University of Turin Turin Italy
Cardiothoracic Department University Hospital Udine Italy
Cardiovascular Surgery Department University Hospital Gregorio Marañón Madrid Spain
Center for Global Health National Health Institute Rome Italy
Centre Hospitalier Annecy Genevois Épagny Metz Tessy France
Department of Cardiac Surgery Centre Cardiologique du Nord de Saint Denis Paris France
Department of Cardiac Surgery Glenfield Hospital Leicester UK
Department of Cardiac Surgery Ziekenhuis Oost Limburg Genk Belgium
Department of Cardiothoracic Surgery University Hospital Muenster Muenster Germany
Department of Cardiovascular Surgery University Heart and Vascular Center Hamburg Hamburg Germany
Department of Medicine South Karelia Central Hospital University of Helsinki Lappeenranta Finland
Department of Thoracic and Cardiovascular Surgery University of Franche Comte Besancon France
Division of Cardiac Surgery University of Verona Medical School Verona Italy
German Centre for Cardiovascular Research Partner Site Munich Heart Alliance Munich Germany
Heart and Lung Center Helsinki University Hospital University of Helsinki 00029 Helsinki Finland
Liverpool Centre for Cardiovascular Sciences Liverpool Heart and Chest Hospital Liverpool UK
LMU University Hospital Ludwig Maximilian University Munich Germany
Citace poskytuje Crossref.org
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