Effect Modification of Sex and Age for the Hospital Volume-Outcome Relationship in Abdominal Aortic Aneurysm Treatment: Secondary Data Analysis of the Nationwide German Diagnosis Related Groups Statistics From 2005 to 2014.
Age Factors
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal
/ diagnostic imaging
Diagnosis-Related Groups
Elective Surgical Procedures
Endovascular Procedures
/ adverse effects
Female
Germany
Hospital Mortality
Hospitals, High-Volume
Hospitals, Low-Volume
Humans
Male
Middle Aged
Retrospective Studies
Risk Assessment
Risk Factors
Sex Factors
Time Factors
Treatment Outcome
Vascular Surgical Procedures
/ adverse effects
endovascular aortic repair
hospital performance
hospital volume
in‐hospital mortality
secondary data analysis
sex differences
sex specific
Journal
Journal of the American Heart Association
ISSN: 2047-9980
Titre abrégé: J Am Heart Assoc
Pays: England
ID NLM: 101580524
Informations de publication
Date de publication:
17 03 2020
17 03 2020
Historique:
entrez:
17
3
2020
pubmed:
17
3
2020
medline:
10
3
2021
Statut:
ppublish
Résumé
Background Trials and registries associated female sex and high age with unfavorable outcomes in abdominal aortic aneurysm treatment. Many studies showed an inverse correlation between annual hospital volume and in-hospital mortality. The volume-outcome relationship has not been investigated separately for women and men or across the age range. The aim was to analyze whether sex and age are effect modifiers or confounders of the volume-outcome association. Methods and Results In a nationwide setting, all in-hospital cases from 2005 to 2014 with a diagnosis of intact abdominal aortic aneurysm and procedure codes for endovascular or open aortic repair were included. Primary outcome was in-hospital mortality. Using a multilevel multivariable regression model, hospital volume was modeled as a continuous variable. Separate analyses were performed for women and men and for predefined age groups. A total of 94 966 cases were included (12% women; median age, 72 years). Mortality was 4.9% in women and 3.0% in men (3.2% overall). Mortality increased with age. Although there was no significant volume-outcome association in women (
Identifiants
pubmed: 32172655
doi: 10.1161/JAHA.119.014534
pmc: PMC7335519
doi:
Types de publication
Comparative Study
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
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