Pediatric Cardiac Surgery : Hannan EL, Racz M, Kavey RE et al
Pediatric Cardiac Surgery: The effect of Hospital and Surgeon Volume on In Hospital Mortality
Pediatrics 101: 963-969, 1998
An inverse relationship between adverse outcomes for certain types of patients and the amount of experience of health care providers in treating such patients has been documented. The relationship between in-hospital mortality and both surgeon and hospital volume for pediatric cardiac surgery in New York State between 1992 and 1995 was retrospectively analyzed.
The information came from the part of New York’s Surgery Reporting System database dedicated to pediatric cardiac surgery, which comprises all 7169 pediatric cardiac surgeries performed from 1992 to 1995 in the 16 New York State approved and certified hospitals. The risk-adjusted mortality rates for hospital and surgeon volume ranges were calculated with adjustments made for severity of illness.
After controlling for severity of illness, hospitals with annual pediatric cardiac surgical volumes of less than 100 cases had significantly higher mortality rates than hospitals with volumes of 100 or more. Surgeon with annual volumes of less than 75 cases had significantly higher mortality rates than surgeons with annual volumes of 75 or more.
Both the annual hospital and surgeons volume were found to be significantly related to in-hospital mortality of cardiac surgery patients in this population-based retrospective study, even after controlling for patient age, procedure complexity and other clinical risk factors. What is even more significant, these differences persisted even with low complexity pediatric cardiac surgery procedures.