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(Circulation. 2003;108:e9012.)
© 2003 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

An extract of the first 250 words of the full text is provided, because this article has no abstract.

High-Volume Hospitals and Surgeons Still Safest

An updated study demonstrates that the surgeons who perform the most coronary artery bypass surgeries and the hospitals where such surgery is performed most commonly remain the safest, according to a report in this week’s issue of the journal Circulation (Circulation. 2003;108:795–801)[Abstract/Free Full Text].

The study, led by Edward L. Hannan, PhD, of the State University of New York at Albany, sought to update older reviews of such procedures. Data from New York State’s clinical coronary artery bypass graft surgery registry from 1997 to 1999 were reviewed to determine the impact of annual hospital and surgeon volume on the death rates of patients in the hospital. The data were adjusted for differences in severity of illness.

The risk-adjusted mortality rate for patients who underwent their surgeries in hospitals where 600 or more such procedures were performed annually and whose surgeons performed 125 or more such operations each year was 1.89%. When the surgery was performed by surgeons who did fewer than 125 CABG procedures each year in hospitals where the annual volume was less than 600, the risk-adjusted mortality rate was much higher—2.67%.

However, the researchers warned that the data do not represent an absolute. "It is also important to emphasize that even if mortality rates were reduced if patients were channeled to higher-volume hospitals, there are numerous challenges in implementing such a policy, including travel time constraints, unwillingness of patients to travel to distant hospitals, the loss of continuity with the primary physician, and the potential detrimental effects . . . [Full Text of this Article]