2089 correspondence reflects improvements in patient care rather than case selection.In response to de Miguel-Yanes et al.: we did not evaluate the subgroup with diabetes in our initial analysis.However, in contrast with de Miguel-Yanes et al., after stratifying our sample according to the presence of diabetes we observed higher mortality for the subgroup of patients with diabetes, and this difference persisted over time.We agree with Hussain and Al-Omran that surgical volume is an important predictor of outcomes for abdominal aortic aneurysm repair. 1 In our previous work, we found that the relationship between hospital volume and outcomes was quite different for endovascular repair versus open repair and that experience with one type of repair did not carry over to improved outcomes in the other type of repair.We therefore did not conduct propensity-score matching for procedure volume in our analysis, since doing so would have been helpful only for comparisons of the same procedure, not for comparisons between different procedures.
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Greco et al. (2015) studied this question.