Hospital volume found linked to EVAR success

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Higher hospital and surgeon volumes have been found to be correlated with improved outcomes after open repair of abdominal aortic aneurysm (AAA). However, the effect of both surgeon and hospital volumes on open and endovascular repair (EVAR) in the current era remains unclear, according to Sara L. Zettervall, MD.

Zettervall, of the Beth Israel Deaconess Medical Center in Boston, will present a study that she and her colleagues performed on all Medicare beneficiaries who underwent elective AAA repair from 2001 to 2008.

Dr. Sara Zettervall
Sara L. Zettervall

They measured volume by repair type for the one-year period before repair and assessed all AAA repairs (including elective, ruptured, contiguous, etc.). They used continuous volume and also divided volume into quintiles, which were constructed based on annual volumes across the entire study period for surgeons and hospitals, according to Zettervall.

A total of 122,495 patients underwent repair of an aortic aneurysm (open: 45,451 patients, EVAR: 77,044).

When examining surgeon and hospital volume together, EVAR perioperative mortality was not signficantly associated with surgeon volume, but was with hospital volume (OR, 1.5), according to Zettervall.

“Surgeon volume independently predicts mortality following open AAA repair,” said Zettervall. “In contrast, surgeon volume was not associated with mortality following EVAR, but hospital volume remained associated with patient survival,” she concluded.

Vess Paper
SESSION 1
8:00 – 11:30 a.m. Thursday
Maryland Ballroom A

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