Objectives: We sought to evaluate the effect of centre volume on survival when extracorporeal membrane oxygenation (ECMO) is used as a bridge to lung transplantation (LTx).
Methods: We performed a retrospective analysis of the United Network for Organ Sharing data on adult lung transplantations performed between 2000 and 2014. Centres were categorized based on volume of transplants into low-, medium- and high-volume centres (1-5, 6-15 and >15, respectively). Baseline characteristics were assessed and a Kaplan-Meier analysis was used to estimate survival with log-rank test. We used multivariate Cox regression analysis to estimate the risk of post-transplant 1-year mortality between centres.
Results: A total of 342 adult recipients were bridged on ECMO. Of these recipients, 88 (25.7%) were bridged in low, 89 (26%) in medium and 165 (48.2%) in high-volume centres. Patients in medium-volume centres were more likely to be older compared with those in low-volume and high-volume centres with a median age of 56, 46 and 49 years, respectively. High-volume centres reported the highest proportion (94.6%) of bilateral lung recipients, followed by low-volume (86.4%) and medium-volume centres (77.5%). The 30-day survival for the three groups was similar but 1-year survival was higher in high-volume centres (80.8) compared with medium-volume centres (70.0%) and low-volume centres (61.9%). The risk of 1-year mortality in low-volume centres was higher compared with high-volume centres in adjusted analysis (hazard ratio 2.74, 95% confidence interval 1.61-4.68, P = 0.01).
Conclusions: Lowest volume centres have lowest survival and there exists a volume threshold at which better outcomes are achieved.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/icvts/ivv379 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Objectives: To evaluate the benefit of neoadjuvant chemotherapy (NAC) for patients with high-risk upper tract urothelial carcinoma (UTUC) using a large, well-curated multi-institutional database.
Patients And Methods: This study was a multi-institutional retrospective analysis conducted by the UTUC Collaborative Network (UCAN), combining data from 2276 patients with UTUC who underwent radical nephroureterectomy at seven high-volume tertiary care centres in the United States. The UCAN data were analysed to evaluate the impact of response to NAC on survival outcomes in patients with UTUC.
Permanent hypoparathyroidism following total thyroidectomy - Incidence and preventative strategies without imaging adjuncts.
Am J Surg
January 2025
Department of Endocrine Surgery, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia; Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Introduction: Permanent hypoparathyroidism (pHypoPT) is the most common permanent complication of total thyroidectomy. We aim to describe the incidence and predictors of hypoparathyroidism in a consecutive series of patients treated in a high-volume centre and define strategies to reduce the risk of pHypoPT.
Methods: 1182 patients who underwent total thyroidectomy between April 2018 and June 2022 were analyzed.
Creating pragmatic, rapid-cycle, evidence-based innovation: The Kaiser Permanente Northern California Delivery Science and Applied Research (DARE) program.
Learn Health Syst
January 2025
Division of Research Kaiser Permanente Northern California Oakland California USA.
Introduction: Ongoing crises in the quality, affordability, sustainability, value, and equity of U.S. healthcare call for rapid, massive-scale innovations across multiple specialties.
View Article and Find Full Text PDFReversal of Roux-en-Y Gastric Bypass: A Multi-Centric Analysis of Indications, Techniques, and Surgical Outcomes.
Obes Surg
January 2025
Department of Surgery and Transplantation, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
Background: Roux-en-Y gastric bypass may present long-term complications that require revisional surgery or even reversal to normal anatomy. Data on the indications, surgical technique, and outcomes of RYGB reversal remain scarce.
Methods: We identified 48 cases of RYGB reversals with complete 90-day follow-up within a multi-centric international retrospective database of elective secondary bariatric surgery.
Effectiveness of Low-Volume Versus High-Volume Ropivacaine for Ultrasound-Guided Maxillary Nerve Block in Double-Jaw Surgery: A Randomized Non-inferiority Trial.
Aesthetic Plast Surg
January 2025
State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Anesthesiology, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Background: Ultrasound-guided maxillary nerve block (UGMNB) is applied in oral and maxillofacial surgery to improve perioperative analgesia, decrease the risk of postoperative nausea and vomiting, and enhance recovery. However, the optimum volume of ropivacaine used for UGMNB is undetermined. Thus, it was hypothesized that in patients undergoing double-jaw surgery, low- and high-volume ropivacaine reduces perioperative pain with similar efficacy.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!