Interinstitutional analysis of the outcome after surgery for type A aortic dissection

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064173%3A_____%2F23%3A43925163" target="_blank" >RIV/00064173:_____/23:43925163 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11120/23:43925163

Result on the web

<a href="https://doi.org/10.1007/s00068-023-02248-2" target="_blank" >https://doi.org/10.1007/s00068-023-02248-2</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s00068-023-02248-2" target="_blank" >10.1007/s00068-023-02248-2</a>

Result language

angličtina

Original language name

Interinstitutional analysis of the outcome after surgery for type A aortic dissection

Original language description

PURPOSE: To evaluate the impact of individual institutions on the outcome after surgery for Stanford type A aortic dissection (TAAD). METHODS: This is an observational, multicenter, retrospective cohort study including 3902 patients who underwent surgery for TAAD at 18 university and non-university hospitals. RESULTS: Logistic regression showed that four hospitals had increased risk of in-hospital mortality, while two hospitals were associated with decreased risk of in-hospital mortality. Risk-adjusted in-hospital mortality rates were lower in four hospitals and higher in other four hospitals compared to the overall in-hospital mortality rate (17.7%). Participating hospitals were classified as overperforming or underperforming if their risk-adjusted in-hospital mortality rate was lower or higher than the in-hospital mortality rate of the overall series, respectively. Propensity score matching yielded 1729 pairs of patients operated at over- or underperforming hospitals. Overperforming hospitals had a significantly lower in-hospital mortality (12.8% vs. 22.2%, p &lt; 0.0001) along with decreased rate of stroke and/or global brain ischemia (16.5% vs. 19.9%, p = 0.009) compared to underperforming hospitals. Aggregate data meta-regression of the results of participating hospitals showed that hospital volume was inversely associated with in-hospital mortality (p = 0.043). Hospitals with an annual volume of less than 15 cases had an increased risk of in-hospital mortality (adjusted OR, 1.345, 95% CI 1.126-1.607). CONCLUSION: The present findings indicate that there are significant differences between hospitals in terms of early outcome after surgery for TAAD. Low hospital volume may be a determinant of poor outcome of TAAD. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04831073.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2023

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

European Journal of Trauma and Emergency Surgery

ISSN

1863-9933

e-ISSN

1863-9941

Volume of the periodical

49

Issue of the periodical within the volume

4

Country of publishing house

DE - GERMANY

Number of pages

11

Pages from-to

1791-1801

UT code for WoS article

000939351700001

EID of the result in the Scopus database

2-s2.0-85148903494