To determine, for abdominal aortic aneurysm surgery, whether a previously reported relationship between hospital case volume and mortality rate was observed in Ontario hospitals and to assess the potential impact of age on the mortality rate for elective surgery.
Population based observational study using administrative data.
All Ontario hospitals where repair of abdominal aortic aneurysm as a primary procedure was performed during 1988-92.
These comprised 5492 patients with unruptured abdominal aortic aneurysms and 1203 patients with ruptured abdominal aortic aneurysms admitted to hospital between 1988-92 for repair of abdominal aortic aneurysm as a primary procedure.
In-hospital death and length of in-hospital stay.
The case fatality rate was 3.8% for unruptured abdominal aortic aneurysms and 40.0% for ruptured abdominal aortic aneurysms.
For unruptured cases, after adjustment for patient and hospital covariates, each 10 case per year increase in hospital volume was related to a 6% reduction in relative odds of death (odds ratio (OR) 0.94,95% confidence intervals 0.88,0.99) and 0.29 days reduction (95% CI - 0.22, - 0.35) in postoperative in-hospital stay.
Female sex (OR 1.53,95% CI 1.08,2.18) and transfer from another acute care hospital (OR 4.37,95% CI 2.62,7.29) were associated with increased case fatality rates among patients in the unruptured category.
For ruptured cases, neither the...
Mots-clés Pascal : Chirurgie, Anévrysme, Aorte, Aorte abdominale, Epidémiologie, Age, Hôpital, Taille, Pronostic, Mortalité, Postopératoire, Ontario, Canada, Amérique du Nord, Amérique, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Aorte pathologie, Artère pathologie
Mots-clés Pascal anglais : Surgery, Aneurysm, Aorta, Abdominal aorta, Epidemiology, Age, Hospital, Size, Prognosis, Mortality, Postoperative, Ontario, Canada, North America, America, Cardiovascular disease, Vascular disease, Aortic disease, Arterial disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0233493
Code Inist : 002B25F. Création : 199608.