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Adult Congenital Heart Surgery Outcomes Influenced by Hospital Volume (309617)

Keywords: adult congenital heart disease, congenital heart surgery, hospital volume

In this study, we investigated whether congenital heart surgery (CHS) outcomes were significantly associated with the hospital volume after adjusting for admission information, patient demographic, and hospital information among ACHD patients using logistic regression analysis based on the national inpatient sample (NIS) data. The primary outcome was in-hospital death and the secondary outcome was non-home discharge. Hospital volume was defined as low, medium, and high using tercile thresholds of CHS counts for hospitals. Logistic regression models were fit to identify associations between each outcome and hospital volume. Other covariates were evaluated using purposeful variable selection procedures and those identified as confounders and effect modifiers were included in the models. In the end, model diagnostics were performed and ROC curves were generated to confirm model performance. While there was no significant association between in-hospital death and hospital volume, length of stay in hospital was a key to an association between non-home discharge and hospital volume. With at least a day-hospitalization, hospital volume hardly affected CHS outcomes in non-home discharge.