This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Systematic review and meta‐analysis of the relationship between hospital volume and outcome for lower limb arterial surgery. BJS 2010; 97: 797-803.
Published: 20th April 2010
Authors: A. I. Awopetu, P. Moxey, R. J. Hinchliffe, K. G. Jones, M. M. Thompson, P. J. E. Holt et al.
Background
The aim was to investigate whether a relationship existed between case volume and outcome for lower limb vascular surgical procedures.
Method
PubMed, Embase, the Cochrane Library and Google Scholar were searched for all articles on population‐based studies on the volume–outcome relationship for lower limb vascular surgery at hospital level. Outcomes were mortality and subsequent amputation after lower limb vascular surgery. The data were subjected to meta‐analysis by outcome.
Results
Some 452 093 patients from ten studies were included in the systematic review and five studies were included in meta‐analyses. Seven of these articles found a significant positive hospital–volume outcome relationship. The pooled effect estimate for mortality was odds ratio (OR) 0·81 (95 per cent confidence interval 0·71 to 0·91) and that for amputation was OR 0·88 (0·79 to 0·98), with better results being found after surgery at higher‐volume hospitals. Significant heterogeneity was seen in the data.
Conclusion
Higher‐volume hospitals were associated with reduced amputation and mortality rates after lower limb vascular surgery. These data were not as conclusive as those for other vascular surgical procedures owing to significant heterogeneity. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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