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Association of Volume With Outcome of Coronary Artery Bypass Graft Surgery: Scheduled vs Nonscheduled Operations
Abstract
Empirical evidence suggests that mortality rates for coronary artery bypass graft (CABG) surgery are lower in hospitals that perform a higher volume of the procedure. In recent years, the criteria for CABG surgery have been expanded to include patients with a wide variety of co-morbidities. To address the question of whether the volume-outcome relationship continues to exist for this new group of patients, discharge abstracts for 18,986 CABG operations at 77 hospitals in California in 1983 were analyzed using multiple-regression techniques. Higher-volume hospitals had lower in-hospital mortality (adjusted for case mix); this effect was greatest in patients who might be characterized as having "non-scheduled" CABG surgery. Higher-volume hospitals also had shorter average postoperative lengths of stay and fewer patients with extremely long stays. The results of this study suggest that the greatest improvement in average outcomes for CABG surgery would result from the closure of low-volume surgery units.
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Citations
Cited by
Halm, E. A., Lee, C., & Chassin, M. R. (2002) · Annals of Internal Medicine · doi:10.7326/0003-4819-137-6-200209170-00012 · Cited by 1,704
2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery
Hillis, L. D., Smith, P. K., Anderson, J. L., Bittl, J. A., Bridges, C. R., Byrne, J. G., Cigarroa, J. E., DiSesa, V. J., Hiratzka, L. F., Hutter, A. M., et al. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2011.08.009 · Cited by 820
McClellan, M. (1994) · JAMA · doi:10.1001/jama.1994.03520110039026 · Cited by 773
The Performance of Intensive Care Units: Does Good Management Make a Difference?
Shortell, S. M., Zimmerman, J. E., Rousseau, D. M., Gillies, R. R., Wagner, D. P., Draper, E. A., Kanus, W. A., & Duffy, J. (1994) · Medical Care · doi:10.1097/00005650-199405000-00009 · Cited by 733
A systematic review of the impact of volume of surgery and specialization on patient outcome
Chowdhury, M. M., Dagash, H., & Pierro, A. (2007) · British Journal of Surgery · doi:10.1002/bjs.5714 · Cited by 608
Metadata
- Authors
- Showstack, J. A.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 1987-02-13
- Volume
- 257
- Issue
- 6
- Pages
- 785
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2090142454
- Cited by
- 272
- References
- 0
- FWCI
- 12.80
- Type
- journal article
- Language
- en
- Open access
- closed
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- Showstack, J. A. (1987). Association of Volume With Outcome of Coronary Artery Bypass Graft Surgery: Scheduled vs Nonscheduled Operations. JAMA. https://doi.org/10.1001/jama.1987.03390060075027
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
