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

 -  2016 
<br/><br/>Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006 
<br/><br/> 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). 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>0002-9610 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Lung Transplantation/mo [Mortality]<br/>*Quality of Health Care<br/>*Survival Rate/td [Trends]<br/>*Workload<br/>Female<br/>Hospital Mortality<br/>Humans<br/>Kaplan-Meier Estimate<br/>Lung Transplantation/sn [Statistics & Numerical Data]<br/>Lung Transplantation/st [Standards]<br/>Male<br/>Middle Aged<br/>Retrospective Studies<br/>United States/ep [Epidemiology]
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Washington Hospital Center
<br/><br/><label>Index Terms--Occupation: </label><br/>Surgery/Surgical Critical Care
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article<br/>Research Support, Non-U.S. Gov't