Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: Recent analyses of the volume-outcome relationship for percutaneous coronary intervention (PCI) have suggested a less robust association than previously reported. It is unknown if novel factors such as lifetime operator experience influence this relationship.
Objectives: To assess the relationship between annual volumes and outcomes for PCI and determine whether lifetime operator experience modulates the association.
Methods: Annual PCI volumes for facilities and operators within the Veterans Affairs Healthcare System and their relationship with 30-day mortality following PCI were described. The influence of operator lifetime experience on the volume-outcome relationship was assessed. Hierarchical logistic regression was used to adjust for patient and procedural factors.
Results: 57,608 PCIs performed from 2013 to 2018 by 382 operators and 63 institutions were analyzed. Operator annualized PCI volume averaged 47.6 (standard deviation [SD] 49.1) and site annualized volume averaged 189.2 (SD 105.2). Median operator experience was 9.0 years (interquartile range [IQR] 4.0-15.0). There was no independent relationship between operator annual volume, institutional volume, or operator lifetime experience with 30-day mortality (p > 0.10). However, the interaction between operator volume and lifetime experience was associated with a marginal decrease in mortality (odds ratio [OR] 0.9998, 95% CI 0.9996-0.9999).
Conclusions: There were no significant associations between facility or operator-level procedural volume and 30-day mortality following PCI in a nationally integrated healthcare system. There was a marginal association between the interaction of operator lifetime experience, operator annual volume, and 30-day mortality that is unlikely to be clinically relevant, though does suggest an opportunity to explore novel factors that may influence the volume-outcome relationship.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9072598 | PMC |
| http://dx.doi.org/10.1016/j.carrev.2021.11.008 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Causes of Death After Surgery Among Cancer Patients: A Population-based Cohort Study.
Int J Surg
September 2025
State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China.
Introduction: Recent advancements in surgical techniques and perioperative care have improved cancer survival rates, yet postoperative comorbidity and mortality remain a critical concern. Despite progress in cancer control, systematic analyses of long-term mortality trends and competing risks in surgery-intervened cancer populations are lacking. This study aimed to quantify temporal patterns of postoperative mortality causes across 21 solid cancers and identify dominant non-cancer risk factors to inform survivorship care strategies.
View Article and Find Full Text PDFCombination therapy does not decrease 30-day mortality but increases antibiotic consumption in methicillin-sensitive bacteraemia.
J Chemother
September 2025
Department of Infectious Diseases and Clinical Microbiology, Gazi University Medical School, Ankara, Türkiye.
Purpose: The study aimed to compare the impact of combination and monotherapy on mortality, antibiotic consumption using 'Days of Therapy (DOT)', and antibiotic-related adverse events in patients with methicillin-susceptible (MSSA) bacteraemia.
Methods: This retrospective study included all adult patients (>18 years) with MSSA bacteraemia who received either monotherapy (beta-lactam alone) or combination therapy (beta-lactam plus teicoplanin or daptomycin or linezolid) between 2018 and 2023. Mortality, antibiotic consumption, and factors predicting mortality were analysed.
Left ventricular unloading in patients with cardiogenic shock treated with veno-arterial extracorporeal membrane oxygenation.
Eur Heart J Open
September 2025
Calderdale and Huddersfield NHS Foundation Trust, Acre St, Lindley, Huddersfield HD3 3EA, UK.
Aims: Cardiogenic shock remains a significant cause of mortality despite multiple advancements in medical interventions. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides crucial circulatory support but also increases left ventricular (LV) after-load, potentially worsening outcomes. Effective LV unloading strategies can enhance patient survival during VA-ECMO treatment.
View Article and Find Full Text PDFShort-Term Outcomes Following Transcatheter Valve-in-Valve Implantation With Portico or Navitor Valves: The Barts Heart Center Experience.
Catheter Cardiovasc Interv
September 2025
Department of Cardiology, Barts Heart Center, Barts Health NHS Trust, London, UK.
Background: Degeneration of surgical bioprosthetic aortic valves is increasingly common. Redo surgical aortic valve replacement carries substantial morbidity and mortality, particularly in elderly or high-risk patients. Valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) has become an established alternative, though data on the performance of self-expanding Portico and Navitor valves remain limited.
View Article and Find Full Text PDFThe Changing Landscape of Lung Cancer Resection Outcomes Over the Past two Decades.
Clin Lung Cancer
August 2025
Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec City, Québec, Canada.; Department of Medicine, Université Laval, Québec City, Québec, Canada.; Pulmonary Hypertension Research Group, Québec, Canada.. Electronic address: steeve.provencher@criuc
Introduction: Recent advances in cancer management may have transformed the overall prognosis of patients undergoing lung cancer resection. This study aimed to assess the changes in the long-term survival of patients undergoing surgery for lung cancer over the last 2 decades and to identify the risk factors modulating the postoperative prognosis.
Methods: This single-center retrospective study included nonsmall cell lung cancer patients who underwent lung resection between 2008 and 2020.