The association between surgeon and hospital volume after AAA repair have been well described in the literature. (1-3, 12-15) However, to our knowledge, there are no data quantifying the impact of patient, surgeon and hospital level factors on risk of death following only open intact repair using the validated Medicare risk categorization score. Although several studies have generally attempted to control for measures of preoperative risk in OAR, our study is the first to assess Open intact repair in patients of similar preoperative mortality risk as determined by the validated MRC score. (4, 7, 16) This helps us assess if the mortality associated with OAR is increasing in patients with similar risk categories as less hospitals and surgeons perform the procedure and allows us to investigate the effect of volume in this association.
Using data from the MDHSCRC, we reported the effects of MRC, hospital volume, surgeon volume, year if procedure, and cost of procedure on in-hospital mortality following OAR. We obtained an in-hospital mortality rate of 5.04%, this was slightly higher than 4.8% reported by Schermerhorn and Giles et al, (2, 7) and much lower than 14% reported by Hicks et al using the much larger American College of Surgeons National Surgical …show more content…
While we may be reducing mortality in high risk cases by regionalization, this may not be applicable in medium and low risk cases. Opponents of regionalization note such efforts disproportionally displace patients in rural settings, increase the travel costs associated with health care, and overburden large institutions, which are already frequently over capacity. However, early studies have demonstrated better patient outcomes through these efforts, with only moderate increases in travel time for most patients. (5,
Using data from the MDHSCRC, we reported the effects of MRC, hospital volume, surgeon volume, year if procedure, and cost of procedure on in-hospital mortality following OAR. We obtained an in-hospital mortality rate of 5.04%, this was slightly higher than 4.8% reported by Schermerhorn and Giles et al, (2, 7) and much lower than 14% reported by Hicks et al using the much larger American College of Surgeons National Surgical …show more content…
While we may be reducing mortality in high risk cases by regionalization, this may not be applicable in medium and low risk cases. Opponents of regionalization note such efforts disproportionally displace patients in rural settings, increase the travel costs associated with health care, and overburden large institutions, which are already frequently over capacity. However, early studies have demonstrated better patient outcomes through these efforts, with only moderate increases in travel time for most patients. (5,