Heart Care Info - Heart Disease Prevention & Treatment

Association of Center Volume With Mortality and Complications in Pediatric Heart Surgery

SK Pasquali, JS Li, DS Burstein, S Sheng... - Pediatrics, 2012 - Am Acad Pediatrics OBJECTIVE: Previous analyses have suggested center volume is associated with outcome in children undergoing heart surgery. However, data are limited regarding potential mediating factors, including the relationship of center volume with postoperative ...

RESULTS: A total of 35 776 patients (68 centers) were included. Overall, 40.6% of patients had ≥1 complication, and the in-hospital mortality rate was 3.9%. The mortality rate in those patients with a complication was 9.0%. In multivariable analysis, lower center volume was significantly associated with higher in-hospital mortality. There was no association of center volume with the rate of postoperative complications, but lower center volume was significantly associated with higher mortality in those with a complication (P = .03 when volume examined as a continuous variable; odds ratio in centers with 350 cases per year = 1.59 [95% confidence interval: 1.16–2.18]). This association was most prominent in the higher surgical risk categories.