Key result
Top-quartile hospital AVR volume linked to ~42% lower in-hospital mortality vs lowest quartile.
Why the study?
Nationally representative estimates of in-hospital mortality after aortic valve replacement are needed to evaluate the applicability of Society of Thoracic Surgeons database results to other US institutions.
Does higher hospital procedure volume reduce in-hospital mortality in patients undergoing aortic valve replacement?
Observational (n=46,397)
Yes
Does higher hospital procedure volume reduce in-hospital mortality in patients undergoing aortic valve replacement?
Odds Ratio: 0.58 (95% CI 0.42–0.81)
Higher hospital volume for aortic valve replacement is associated with significantly lower in-hospital mortality, and national mortality rates are comparable to those in the STS database.
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May support selective AVR referral to high-volume centers; leaves open whether thresholds should guide policy or improve outcomes.
Astor et al. (2000) conducted an observational in Aortic valve replacement (n=46,397). Highest quartile of procedure-specific hospital volume vs. Lowest quartile of procedure-specific hospital volume was evaluated on In-hospital mortality (adjusted OR 0.58, 95% CI 0.42 to 0.81). The highest quartile of procedure-specific hospital volume for aortic valve replacement was associated with lower in-hospital mortality versus the lowest quartile (adjusted OR 0.58; 95% CI 0.42-0.81).
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