Effect of hospital volume on in-hospital mortality for renal artery bypass.

Authors :: Modrall JG
Rosero EB
Smith ST
Arko FR 3rd
Valentine RJ
Clagett GP
Timaran CH
Source :: Vascular and endovascular surgery [Vasc Endovascular Surg] 2009 Aug-Sep; Vol. 43 (4), pp. 339-45. Date of Electronic Publication: 2009 Jun 24.
Publication Year :: 2009
Abstract: Background: A recent report determined that the nationwide mortality for renal artery bypass (RAB) is surprisingly high-10%. We hypothesized that operative mortality for RAB is related to the volume of such operations performed in each center.<br />Methods: The Nationwide Inpatient Sample was analyzed to identify patients undergoing RAB for the years 2000-2005. In-hospital mortality for RAB was compared between hospitals.<br />Results: During the study period, RAB was performed on 7413 patients with an overall in-hospital mortality of 9.6%. The multivariate logistic regression analyses revealed that after adjusting for surgical risk, increasing hospital volume was significantly associated with decreased in-hospital mortality for RAB (odds ratio 0.98; 95% confidence interval, 0.96-0.99; P=.015).<br />Conclusions: Patient risk profile and hospital volume are critical determinants of in-hospital mortality for RAB, which should be factored into decision making for patients requiring intervention for renovascular disease.