Featured Research

from universities, journals, and other organizations

For older heart-transplant patients, hospitals doing the most operations yield better outcomes

Date:
May 9, 2011
Source:
Johns Hopkins Medical Institutions
Summary:
Older, sicker heart-transplant recipients are significantly more likely to be alive a year after their operations if they have their transplants at hospitals that do a large number of them annually new research suggests. These patients fare less well at low-volume centers, the research shows.

Older, sicker heart-transplant recipients are significantly more likely to be alive a year after their operations if they have their transplants at hospitals that do a large number of them annually new Johns Hopkins research suggests. These patients fare less well at low-volume centers, the research shows.

Related Articles


The findings, to be presented May 9 at the American Association of Thoracic Surgeons' annual meeting in Philadelphia, add more support to the notion that patients do better when treated at medical centers that handle a higher number of cases similar to theirs.

"There's growing evidence throughout medicine and surgery that the volume of cases done at a given medical center has an impact on outcomes," says George J. Arnaoutakis, M.D., a general surgery resident at the Johns Hopkins University School of Medicine and the study's leader. "Transplant teams more familiar with a procedure do a better job than those that only do a handful each year."

The researchers combed through United Network of Organ Sharing (UNOS) data from all of the heart transplants done in the United States between January 2000 and December 2009. Using that information, the researchers assigned each of the 17,211 patients a risk score, which took into account known risk factors for complications and/or death after heart transplant, including age, race, cause of heart failure, bilirubin and creatinine levels and whether they had been on life support. The higher the score, the greater risk of death one year after transplantation.

They also ranked the 141 hospitals where the transplants took place into low-, medium- and high-volume centers. Low-volume centers did fewer than six heart transplants a year, while high-volume centers performed more than 15 annually. Just 5.4 percent of heart transplants took place at low-volume centers over that period, while more than 67 percent were done at high-volume centers.

High-risk patients transplanted at low-volume centers had a 67 percent increased risk of death after one year compared with high-risk patients transplanted at high-volume centers. Severity of condition alone did not account for the difference, which diminished among low-risk patients.

"Patients at high risk of mortality should probably only be transplanted at high-volume centers," Arnaoutakis says.

Arnaoutakis cautions that the findings should not be seen as an indictment of the training and skill of surgeons at low-volume centers. Rather, he says, the systems and infrastructure of a center doing few heart transplants are most likely a bigger factor.

"There are certain processes that may be better performed at regional centers of excellence doing more of a certain procedure," he says. "People talk about it with airline pilots -- only at 10,000 hours of flying are they considered expert at flying. The experience of a center can be discussed in similar terms."

Nurses at a high-volume center, for example, may be quicker to recognize complications and intervene earlier, he says. Operating room teams might be better prepared to handle a transplant that occurs in the middle of the night.

"The more you do it, the better you become at doing it," Arnaoutakis says.

Other Johns Hopkins researchers contributed to this study, including Timothy J. George, M.D.; Stuart D. Russell, M.D.; Ashish S. Shah, M.D.; John V. Conte, M.D.; and Eric S. Weiss, M.D., M.P.H.


Story Source:

The above story is based on materials provided by Johns Hopkins Medical Institutions. Note: Materials may be edited for content and length.


Cite This Page:

Johns Hopkins Medical Institutions. "For older heart-transplant patients, hospitals doing the most operations yield better outcomes." ScienceDaily. ScienceDaily, 9 May 2011. <www.sciencedaily.com/releases/2011/05/110509113723.htm>.
Johns Hopkins Medical Institutions. (2011, May 9). For older heart-transplant patients, hospitals doing the most operations yield better outcomes. ScienceDaily. Retrieved October 24, 2014 from www.sciencedaily.com/releases/2011/05/110509113723.htm
Johns Hopkins Medical Institutions. "For older heart-transplant patients, hospitals doing the most operations yield better outcomes." ScienceDaily. www.sciencedaily.com/releases/2011/05/110509113723.htm (accessed October 24, 2014).

Share This



More Health & Medicine News

Friday, October 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Doctor in NYC Quarantined With Ebola

Doctor in NYC Quarantined With Ebola

AP (Oct. 24, 2014) An emergency room doctor who recently returned to the city after treating Ebola patients in West Africa has tested positive for the virus. He's quarantined in a hospital. (Oct. 24) Video provided by AP
Powered by NewsLook.com
Breakfast Debate: To Eat Or Not To Eat?

Breakfast Debate: To Eat Or Not To Eat?

Newsy (Oct. 23, 2014) Conflicting studies published in the same week re-ignited the debate over whether we should be eating breakfast. Video provided by Newsy
Powered by NewsLook.com
Ebola Fears Keep Guinea Hospitals Empty

Ebola Fears Keep Guinea Hospitals Empty

AP (Oct. 23, 2014) Fears of Ebola are keeping doctors and patients alike away from hospitals in the West African nation of Guinea. (Oct. 23) Video provided by AP
Powered by NewsLook.com
Despite Rising Death Toll, Many Survive Ebola

Despite Rising Death Toll, Many Survive Ebola

AP (Oct. 23, 2014) The family of a Dallas nurse infected with Ebola in the US says doctors can no longer detect the virus in her. Despite the mounting death toll in West Africa, there are survivors there too. (Oct. 23) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins