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Procedural volume and survival after lung transplantation in the United States: the need to look beyond volume in the establishment of quality metrics.

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Citation: American Journal of Surgery. 211(4):671-6, 2016 Apr.PMID: 26830718Institution: MedStar Washington Hospital CenterDepartment: Surgery/Surgical Critical CareForm of publication: Journal ArticleMedline article type(s): Journal Article | Research Support, Non-U.S. Gov'tSubject headings: *Lung Transplantation/mo [Mortality] | *Quality of Health Care | *Survival Rate/td [Trends] | *Workload | Female | Hospital Mortality | Humans | Kaplan-Meier Estimate | Lung Transplantation/sn [Statistics & Numerical Data] | Lung Transplantation/st [Standards] | Male | Middle Aged | Retrospective Studies | United States/ep [Epidemiology]Year: 2016 Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006ISSN:

0002-9610

Name of journal: American journal of surgeryAbstract: BACKGROUND: We sought to evaluate the effect of center volume on patient survival.CONCLUSIONS: Post-LT survival in low volume centers is significantly lower than in high volume centers but the explanatory power of volume as a predictor of survival is low.Copyright © 2016 Elsevier Inc. All rights reserved.METHODS: We performed a retrospective analysis on nationwide data from the Scientific Registry of Transplant Recipients provided by United Network for Organ Sharing pertaining to lung transplantation (LT) recipients transplanted between 2005 and 2013. Centers were categorized into 4 groups based on their annual volume as follows: less than 20, 20 to 29, 30 to 39, and greater than or equal to 40 LTs. Baseline characteristics were compared and Kaplan-Meier analysis was used to estimate survival.RESULTS: A total of 13,506 adult recipients underwent LT during the study period. Of these, 2,491 (18.4%) patients were transplanted in centers with volume less than 20, 2,562 (19.0%) in centers with volume 20 to 29, 2,998 (22.2%) in centers with volume 30 to 39, and 5,455(40.4%) in centers with volume greater than or equal to 40. Survival was poorest in the lowest volume centers (1-year 81.4% vs 85.5% and 5-year 49.7% vs 56.5%, respectively).All authors: Aboagye J, D'Cunha J, Girgis R, Hayanga HK, Hayanga JA, Khaghani A, Lira A, Vlahu TFiscal year: FY2016Digital Object Identifier:

http://dx.doi.org/10.1016/j.amjsurg.2015.12.010

Date added to catalog: 2016-09-07

Holdings ( 1 )
Title notes ( 6 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	26830718	Available		26830718

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006

BACKGROUND: We sought to evaluate the effect of center volume on patient survival.

CONCLUSIONS: Post-LT survival in low volume centers is significantly lower than in high volume centers but the explanatory power of volume as a predictor of survival is low.Copyright © 2016 Elsevier Inc. All rights reserved.

METHODS: We performed a retrospective analysis on nationwide data from the Scientific Registry of Transplant Recipients provided by United Network for Organ Sharing pertaining to lung transplantation (LT) recipients transplanted between 2005 and 2013. Centers were categorized into 4 groups based on their annual volume as follows: less than 20, 20 to 29, 30 to 39, and greater than or equal to 40 LTs. Baseline characteristics were compared and Kaplan-Meier analysis was used to estimate survival.

RESULTS: A total of 13,506 adult recipients underwent LT during the study period. Of these, 2,491 (18.4%) patients were transplanted in centers with volume less than 20, 2,562 (19.0%) in centers with volume 20 to 29, 2,998 (22.2%) in centers with volume 30 to 39, and 5,455(40.4%) in centers with volume greater than or equal to 40. Survival was poorest in the lowest volume centers (1-year 81.4% vs 85.5% and 5-year 49.7% vs 56.5%, respectively).

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