High-risk patients undergoing heart transplants at low-volume transplant centers have a higher mortality than rate than those at high-volume centers, according to research presented at the annual meeting of the American Association for Thoracic Surgery.
George J. Arnaoutakis, MD, of the Johns Hopkins University School of Medicine in Baltimore, and colleagues evaluated data on 17,211 patients who underwent heart transplantation in the United States between Jan. 2000 and Dec. 2009 and assigned each patient a risk score. The 141 hospitals where the heart transplants took place were categorized as low-, medium- or high-volume centers.
Investigators found that high-risk patients transplanted at low-volume centers had a 67 percent increased risk of death one year post-surgery. For both 30-day and one-year survival, there was a significant positive interaction between a center's volume and recipient risk score, indicating the effect of risk on mortality is greater at low-volume centers than would be expected by either variable individually. Overall, center volume mattered less for low-risk patients.
The study researchers said the data strongly supports a mandate for high-risk patients to undergo transplants at high-volume centers only.
"There are certain processes that may be better performed at regional centers of excellence doing more of a certain procedure," Dr. Arnaoutakis said in a statement. "People talk about it with airline pilots — only at 10,000 hours of flying are they considered expert at flying. The experience of a center can be discussed in similar terms."
Read the release on the study of mortality rates at high-volume surgery centers.
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George J. Arnaoutakis, MD, of the Johns Hopkins University School of Medicine in Baltimore, and colleagues evaluated data on 17,211 patients who underwent heart transplantation in the United States between Jan. 2000 and Dec. 2009 and assigned each patient a risk score. The 141 hospitals where the heart transplants took place were categorized as low-, medium- or high-volume centers.
Investigators found that high-risk patients transplanted at low-volume centers had a 67 percent increased risk of death one year post-surgery. For both 30-day and one-year survival, there was a significant positive interaction between a center's volume and recipient risk score, indicating the effect of risk on mortality is greater at low-volume centers than would be expected by either variable individually. Overall, center volume mattered less for low-risk patients.
The study researchers said the data strongly supports a mandate for high-risk patients to undergo transplants at high-volume centers only.
"There are certain processes that may be better performed at regional centers of excellence doing more of a certain procedure," Dr. Arnaoutakis said in a statement. "People talk about it with airline pilots — only at 10,000 hours of flying are they considered expert at flying. The experience of a center can be discussed in similar terms."
Read the release on the study of mortality rates at high-volume surgery centers.
Related Articles on Surgery Studies:
Study: Robotic Surgery Effective for Hard-to-Reach Larynx Cancer
Small Study Examines Safety of Robotic-Assisted Angioplasty Procedures
Endoscopic Surgery Can Reduce Hospital Length of Stay and Cost For Pancreatitis Patients