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J Thorac Cardiovasc Surg 2006;131:773-774
© 2006 The American Association for Thoracic Surgery

Editorial

Should cardiac surgery be performed in low-volume hospitals?

University of Toronto, Department of Surgery, Toronto, Ontario, Canada

Received for publication December 26, 2005; accepted for publication January 3, 2006.

^_* Address for reprints: Tirone E. David, MD, University of Toronto, Department of Surgery, 200 Elizabeth Street, 13EN219, Toronto, ON M5G 2C4 Canada

The first 20% of the full text of this article appears below.

In the "Brief Communications" section of this issue of The Journal there is a report on hospital mortality after cardiac surgery in Brazil. ¹ An analysis of the database of the Brazilian Universal Health System, which apparently covers 75.4% of the population and more than 80% of all cardiac operations, revealed that from 2000 to 2003, 115,021 patients underwent cardiac surgery with an overall hospital mortality of 8%. The hospital mortality was 6.1% for congenital heart surgery, 7% for coronary artery bypass, 8.9% for heart valve surgery, and 16.5% for "complex" operations (eg, thoracic aorta and combined procedures). Advancing age, female gender, and "complex" operations were variables associated with higher hospital mortality. The investigators also found that hospitals with annual volumes of less than 341 operations had higher mortality than those with more than 340 operations. They correctly suggested that cardiologists should be careful before recommending surgery to treat cardiovascular diseases using European and North American guidelines because the outcomes . . . [Full Text of this Article]

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J. Thorac. Cardiovasc. Surg. 2006 131: 907-909. [Extract] [Full Text] [PDF]

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