Het volume van chirurgische ingrepen en de impact ervan op ... - KCE

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146 Volume Outcome KCE reports 113 Figure 6.10: Funnel plot of the in-hospital mortality of centres after CABG and/or heart valve replacement/repair Figure 6.11: Funnel plot of the in-hospital mortality by centre after isolated CABG
KCE Reports 113 Volume Outcome 147 DESCRIPTION OF DIFFERENCES IN CHARACTERISTICS ACCORDING TO THE VOLUME CATEGORY OF THE HOSPITAL Table 6.18 shows the differences in case mix by volume of centres. The cut off of volume (219 and 401) divide the 29 centres in three groups of equal size. These thresholds correspond more or less to those used by the Agency for Healthcare Research and Quality (upper threshold of 200 CABG per year) and by the Leapfrog Group (450 CABG per year). 29, 126 More information on these international volume thresholds is provided in the discussion section (page 151). Age and gender are not associated with volume. There are, however, a higher proportion of patients with a high Charlson score in low and medium volume centres. This is confirmed by a higher proportion of patients with diabetes and renal disease in these centres in comparison to high volume centres. High volume centres perform more combined operations than low volume centres (18% versus 12%). Length of stay (LOS) was also longer in low volume centres (17.5 days) than in high volume centres (15.1 days). In-hospital mortality was inversely associated with the volume of centres: 6.7% in low volume centres, 5.7% in medium volume centres and 3.6% in high volume centres.
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