Key result
High hospital volume (>50 mitral operations annually) was not correlated with in-hospital mortality for patients undergoing mitral valve repair or replacement.
Why the study?
To investigate whether mitral valve surgery quality differs by hospital volume in New Jersey.
Does hospital volume affect in-hospital mortality and complications in patients undergoing mitral valve surgery?
Cohort (n=2,560)
Yes
Does hospital volume affect in-hospital mortality and complications in patients undergoing mitral valve surgery?
Hospital volume (>50 vs ≤50 operations annually) is not correlated with in-hospital mortality or surgical quality for mitral valve surgery in New Jersey.
No volume-outcome association in NJ MV surgery cautions against strict volume-based referrals; leaves open need for refined quality metrics.
Background and Aim of the Study . To investigate if mitral valve (MV) surgery quality differs by hospital volume in New Jersey (NJ). Methods . Using the NJ State Inpatient Database, patients ≥18 years undergoing MV repair or replacement from 2016–2019 were identified. Centers were considered high‐volume if they performed more than 50 mitral operations annually. Baseline characteristics and outcomes (in‐hospital mortality, seven‐day readmission, hospital length of stay (LOS), and postoperative complications) were evaluated for the population and by center volume. Subanalysis by center volume within each procedure was conducted. Results . Among 2,560 mitral operations, MV replacement (92.3% ( n = 2,362)) was performed more often than repair. High‐ (4) and low‐volume (15) centers performed 1,180 (46.1%) and 1,380 (53.9%) mitral surgeries, respectively. Charlson Comorbidity Indices did not differ by center volume, including in subgroup analyses. Low‐volume centers had higher rates of Hispanic patients, low‐income patients, and readmission rates. High‐volume centers had more transfers, urgent/emergent admissions, higher rates of in‐hospital mortality, and longer LOS. Postoperative complications did not differ by volume. The MV replacement cohort reflected many of the differences seen in the total population, in addition to seeing higher rates of heart failure at high‐volume centers and stroke at low‐volume centers. Within MV repairs, significantly more Hispanic patients presented to low‐volume centers and high‐volume centers had longer LOS. Multivariable analysis indicated that hospital volume was not correlated to in‐hospital mortality for the total population and within each procedure. Conclusions . MV replacement is performed more frequently than repair. Hospital volume is not correlated with MV surgical quality, and more representative quality measures are needed.
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Laraia et al. (2023) conducted a cohort in Mitral valve disease requiring surgery (n=2,560). High hospital volume (>50 mitral operations annually) vs. Low hospital volume was evaluated on In-hospital mortality. High hospital volume (>50 mitral operations annually) was not correlated with in-hospital mortality for patients undergoing mitral valve repair or replacement.
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