Measure what matters: institutional outcome data are superior to the use of surrogate markers to define "center of excellence" for abdominal aortic aneurysm repair

Annals of Vascular Surgery
Kaoru R GoshimaJohn D Hughes

Abstract

Outcome analysis is increasingly being used to develop health-care policy and direct patient referral. For example, the Leapfrog Group health-care quality initiative has proposed "evidence-based hospital" referral criteria for specific procedures including elective abdominal aortic aneurysm repair (AAA-R). These criteria include an annual hospital AAA operative volume exceeding 50 cases and provision of intensive care unit (ICU) care by board-certified intensivists. Outcomes after AAA-R are reportedly influenced by presentation (intact vs. ruptured), operative approach (endovascular vs. open, transperitoneal vs. retroperitoneal), surgeon subspecialty, case volume (hospital and surgeon), and provision of postoperative care by an intensivist. The purpose of this study was to compare our single-center results with those of high-volume centers to assess the validity of the concept that surrogate markers, such as case volume or intensivist involvement, can be used to estimate procedural outcome. A retrospective review was performed of AAA-Rs at one low-volume academic medical center from January 1994 to March 2005. Demographic data, aneurysm diameter and location, operative indications, and repair approach were documented. Postopera...Continue Reading

References

Apr 20, 1999·JAMA : the Journal of the American Medical Association·P J PronovostE Bass
Mar 10, 2001·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·S M ThomasUNKNOWN British Society of Interventional Radiology
May 2, 2001·Journal of Vascular Surgery·W K WilliamsonJ M Porter
Apr 12, 2002·The New England Journal of Medicine·John D BirkmeyerDavid E Wennberg
Jun 4, 2002·Journal of Vascular Surgery·Norman R HertzerEdwin G Beven
Oct 7, 2003·Vascular and Endovascular Surgery·Dipankar Mukherjee
Dec 3, 2003·The New England Journal of Medicine·John D BirkmeyerF Lee Lucas
Jul 16, 2004·Annals of Vascular Surgery·Apostolos K TassiopoulosWilliam H Baker
Oct 16, 2004·The New England Journal of Medicine·Monique PrinssenUNKNOWN Dutch Randomized Endovascular Aneurysm Management (DREAM)Trial Group
Oct 16, 2004·The New England Journal of Medicine·Frank A Lederle
Oct 4, 2005·Annals of Vascular Surgery·Patrick A StoneSarah K Flaherty
Sep 27, 2006·Journal of the American College of Surgeons·Garth H UtterAvery B Nathens

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Citations

Apr 2, 2009·JAMA : the Journal of the American Medical Association·Leslie P KernisanR Adams Dudley
Jan 5, 2011·Current Problems in Surgery·Guillermo A Escobar, Gilbert R Upchurch
Aug 31, 2010·Journal of Vascular Surgery·Mark G DaviesAlan B Lumsden
Sep 21, 2011·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·T L Forbes
Oct 6, 2011·Journal of Vascular Surgery·Matthew ThompsonThomas L Forbes
Feb 7, 2012·The Journal of Thoracic and Cardiovascular Surgery·G Chad HughesPeter K Smith
Jan 16, 2019·Jornal Vascular Brasileiro·Seleno Glauber de Jesus-SilvaRodolfo Souza Cardoso
Oct 16, 2014·Inquiry : a Journal of Medical Care Organization, Provision and Financing·Karl KronebuschMark Schlesinger

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