Volume-outcome relationships in surgical aortic valve replacement and transcatheter aortic valve implantation in aortic valve stenosis - Volume-outcome relationships in surgical aortic valve replacement and transcatheter aortic valve implantation

This study aimed to assess between isolated surgical aortic valve replacement (SAVR) and mortality in patients with aortic valve stenosis using a large-scale study conducted in Japan. Higher hospital volume was significantly associated with reduced mortality, and patients with aortic valve stenosis may benefit from care in high-volume hospitals. Results: The low-volume group, intermediate-volume group, and high-volume group comprised 7383 patients from 330 hospitals, 5253 patients from 76 hospitals, and 3411 patients from 23 hospitals, respectively. The regression analysis accounted for patient sex, height, weight, activities of daily living, and comorbidities as covariates. Relative to the intermediate-volume group, the odds ratios for in-hospital mortality were 1.32 (95% confidence intervals: 1.07-1.61; P<0.01) in the low-volume group and 0.65 (0.48-0.87; P<0.01) in the high-volume group. Conclusion: Higher hospital volume was significantly associated with reduced mortality, and patients with aortic valve stenosis may benefit from care in high-volume hospitals.