Association between operation volume and postoperative mortality in elective endovascular repair of infrarenal abdominal
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onellenfitsch1,2 · K. Meisenbacher2 · M. Ante2 · M. Grilli3 · D. Böckler2 1
Department of Visceral, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Halle (Saale), Germany 2 Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, Heidelberg, Germany 3 Information Services for Medicine and Health Care, Karlsruhe, Germany
Association between operation volume and postoperative mortality in elective endovascular repair of infrarenal abdominal aortic aneurysms: systematic review—continuation Background and aim For numerous operations there is evidence showing an inverse association between hospital and surgeon volumes on one side and perioperative mortality on the other side [1, 2]. Surgeonrelated factors, such as individual experience as well as team-related factors, such as team composition, experience and availability of single team members, and institution-related factors such as the technical equipment and infrastructural framework play an important role in both associations [3, 4]. The first part of this systematic review assessed the association between volume per surgeon and per treating institution, and postoperative mortality for elective open repair of infrarenal abdominal aortic aneurysms (AAA) [5]. It showed that operations performed in high volume centers or by high volume surgeons The German version of this article can be found under https://doi.org/10.1007/s00772020-00692-7 This article is the continuation of: Ronellenfitsch U, Meisenbacher K, Ante M et al. (2020) Association between operation volume and postoperative mortality in elective open repair of infrarenal abdominal aortic aneurysms: systematicreviewhttps://doi.org/10.1007/s00772020-00739-9
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Gefässchirurgie · Suppl 1 · 2020
are associated with a lower mortality. The present second part of the review, relying on all evidence available in the literature, assesses if a corresponding association is also present for elective endovascular repair (EVAR).
Study design and methods A detailed description of the study design and methods can be found in the first part of this work [5]. In brief, a review of several literature databases (PubMed, Cochrane Library, Web of Science Core Collection, Cinahl, Current Content Medizin CCMed and ClinicalTrials.gov) was done using a predefined search strategy for the period from database inception to 1 January 2018. For the present analysis, all studies comparing elective EVAR of infrarenal AAA done in a high volume center with EVAR done in a low volume center, or done by a high volume surgeon with EVAR done by a low volume surgeon were included. Inclusion criteria were that at least one of the outcomes overall postoperative mortality, hospital mortality or 100-day mortality or a combined endpoint, needed to be reported by the study. Regarding the definition of “high volume” and “low volume” centers and study design, there were no exclusion
criteria. The relevant data from single studies were extracted by both independent reviewers and were stored in a database. The specific
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