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Ann Thorac Surg 2006;81:547-553
© 2006 The Society of Thoracic Surgeons

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Original article: Cardiovascular

Exploring the Volume-Outcome Relationship for Off-Pump Coronary Artery Bypass Graft Procedures

^a Eastern Colorado Health Care System, Department of Veterans Affairs Medical Center, Denver, Colorado
^b University of Colorado at Denver and Health Sciences Center, Denver, Colorado
^c Department of Veterans Affairs Central Office, Office of Patient Care Services, Washington, DC

Accepted for publication August 15, 2005.

^_* Address correspondence to Dr Shroyer, Cardiac Research, Eastern Colorado Health Care System, Denver VA Medical Center, 820 Clermont St, Suite 120, Denver, CO 80220 (Email: laurie.shroyer{at}med.va.gov; laurie.shroyer{at}uchsc.edu).

BACKGROUND: The relationship between the surgical case volume and risk-adjusted clinical outcomes has been examined for different surgical specialties. The purpose of this study was to explore the relationship between the off-pump coronary artery bypass graft procedure volumes (OPCABG) with risk-adjusted outcomes within the Department of Veterans Affairs (VA) 44 cardiac surgery programs.

METHODS: Based on VA Continuous Improvement in Cardiac Surgery Program data, the results of 5,076 OPCABG surgical procedures performed between October 1998 and September 2003 were analyzed. Hierarchical logistic regression models evaluated the relationship between OPCABG procedure volume with risk-adjusted 30-day operative mortality, perioperative morbidity, and 180-day mortality. Both a hospital's average OPCABG volume per 6-month period and the hospital's most recent 6-month OPCABG volume were examined.

RESULTS: Hospital OPCABG average volume in a 6-month period ranged from 0.2 to 47.4 procedures; whereas the most recent 6-month OPCABG hospital volume ranged from 0 to 76 OPCABG per site. No relationship between the volume measures and the outcome variables was found.

CONCLUSIONS: We did not find an association between OPCABG volume with short-term mortality, perioperative morbidity, or intermediate-term (180-day) mortality.

This article has been cited by other articles:

				A. H. Sepehripour and T. Athanasiou Is there a surgeon or hospital volume-outcome relationship in off-pump coronary artery bypass surgery? Interact CardioVasc Thorac Surg, February 1, 2013; 16(2): 202 - 207. [Abstract] [Full Text] [PDF]

				S. H. Konety, G. E. Rosenthal, and M. S. Vaughan-Sarrazin Surgical volume and outcomes of off-pump coronary artery bypass graft surgery: Does it matter? J. Thorac. Cardiovasc. Surg., May 1, 2009; 137(5): 1116 - 23.e1. [Abstract] [Full Text] [PDF]

				K. F. Welke Invited commentary Ann. Thorac. Surg., February 1, 2006; 81(2): 553 - 554. [Full Text] [PDF]