[Centralisation of vascular surgical treatment provides better results]

Area of Science:

• Vascular Surgery
• Health Services Research
• Surgical Outcomes

Context:

• The relationship between procedural volume and patient outcomes is established for various surgical specialties.
• In vascular surgery, higher hospital and surgeon volumes are generally linked to improved results.
• Centralization of vascular surgery in Denmark to 9 departments has resulted in most hospitals meeting high-volume criteria.

Purpose:

• To examine the impact of surgeon and hospital volume on outcomes in vascular surgery within a centralized healthcare system.
• To identify specific areas within vascular surgery where volume-outcome relationships may differ.
• To assess adherence to established volume benchmarks for surgeons performing carotid artery and abdominal aortic aneurysm surgery.

Summary:

• Studies indicate that higher surgeon volume is inversely related to stroke and death after carotid artery surgery (low volume <6-12/year).
• Hospital volume's impact is less certain for carotid surgery, but established for abdominal aortic aneurysm surgery (low volume <20/year).
• In Denmark, while most vascular surgeons and all hospitals are high-volume, one-third of surgeons perform fewer than 10 carotid surgeries annually.

Impact:

• Findings highlight potential disparities in surgeon experience for specific procedures like carotid surgery, even within high-volume centers.
• This underscores the need for continued monitoring of individual surgeon volumes to ensure optimal patient safety and outcomes in vascular surgery.
• The study provides insights into the effectiveness of centralized healthcare models in maintaining high-volume standards across institutions.