Key result
Undergoing elective EVAR at high-volume hospitals was associated with lower rates of overall infection compared to low-volume hospitals (3.10% vs 3.51%; P=0.021).
Why the study?
Does undergoing elective AAA repair at high-volume hospitals reduce postoperative infectious complications in Medicare beneficiaries?
Cohort (n=59,365)
Yes
Does undergoing elective AAA repair at high-volume hospitals reduce postoperative infectious complications in Medicare beneficiaries?
Undergoing elective AAA repair at high-volume hospitals is associated with significantly lower postoperative infectious complications and resource utilization in Medicare beneficiaries.
High-volume EVAR linked to modestly fewer infections but should not yet change referral patterns; leaves open causal effects of volume on complications.
OBJECTIVE: A relationship exists between higher hospital volume and lower mortality, yet the impact of hospital volume on infectious complications after elective abdominal aortic aneurysm (AAA) repair is unknown. METHODS: The Medicare database (2005-2007) was utilized. Top 10% for volume were categorized as high-volume (HV) and compared to low-volume (LV) centers for infectious complications and utilization. RESULTS: A total of 42 155 endovascular aneurysm repair (EVAR) and 17 210 open AAA were identified. Mortality in HV was significantly lower than in LV after EVAR and open AAA. After EVAR, HV had lower than LV rates of overall infection (3.10% vs 3.51%; P = .021), PNA (0.94% vs 1.27%, P = .002), and sepsis (0.31% vs 0.45%; P = .03). Length of stay (LOS) and total hospital charges were significantly lower at HV compared to LV after both EVAR and open AAA. CONCLUSION: For Medicare beneficiaries, undergoing elective AAA repair at hospitals performing higher volume significantly reduced postoperative infectious complications and hospital resource utilization. Further analysis identifying systematic reasons for disparities may offer cost savings and improve outcomes.
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Vogel et al. (2011) conducted a cohort in Elective abdominal aortic aneurysm (AAA) (n=59,365). High-volume hospital vs. Low-volume hospital was evaluated on Overall infection after EVAR (p=0.021). Undergoing elective EVAR at high-volume hospitals was associated with lower rates of overall infection compared to low-volume hospitals (3.10% vs 3.51%; P=0.021).
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