Failure to rescue in the era of the lung allocation score: The impact of center volume

Asishana A. Osho; Muath M. Bishawi; Elbert E. Heng; Ejiro Orubu; Aaron Amardey-Wellington; Mauricio A. Villavicencio; Masaki Funamoto

doi:10.1016/j.amjsurg.2020.01.020

Failure to rescue in the era of the lung allocation score: The impact of center volume

Asishana A. Osho, Muath M. Bishawi, Elbert E. Heng, Ejiro Orubu, Aaron Amardey-Wellington, Mauricio A. Villavicencio, Masaki Funamoto

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Background: Failure to Rescue (FTR) is a valuable surgical quality improvement metric. The aim of this study is to assess the relationship between center volume and FTR following lung transplantation. Methods: Using the database of the United Network for Organ Sharing (UNOS) all adult, primary, isolated lung recipients in the United States between May 2005 and March 2016 were identified. FTR was defined as operative mortality after any of five specific complications. FTR was compared across terciles of transplantation centers stratified based on operative volume. Results: 17,185 lung recipients met study criteria. The composite FTR rate (Death following at least one complication) was 20.7%. Following stratification by volume, FTR rates increased from high to middle tercile centers (19.3% vs. 23.0%). Multivariate logistic regression models suggested an independent relationship between higher center volume and lower FTR rates (p < 0.001). Conclusion: Higher volume lung transplantation centers have lower rates of failure to rescue.

Original language	English
Pages (from-to)	793-799
Number of pages	7
Journal	American Journal of Surgery
Volume	220
Issue number	3
DOIs	https://doi.org/10.1016/j.amjsurg.2020.01.020
State	Published - Sep 2020

Keywords

Failure to rescue
Lung transplantation
Mortality
Surgical quality
Survival

Access to Document

10.1016/j.amjsurg.2020.01.020

Cite this

@article{b59eb684f3ea4edba5eb1b0c0dcc4ab1,

title = "Failure to rescue in the era of the lung allocation score: The impact of center volume",

abstract = "Background: Failure to Rescue (FTR) is a valuable surgical quality improvement metric. The aim of this study is to assess the relationship between center volume and FTR following lung transplantation. Methods: Using the database of the United Network for Organ Sharing (UNOS) all adult, primary, isolated lung recipients in the United States between May 2005 and March 2016 were identified. FTR was defined as operative mortality after any of five specific complications. FTR was compared across terciles of transplantation centers stratified based on operative volume. Results: 17,185 lung recipients met study criteria. The composite FTR rate (Death following at least one complication) was 20.7%. Following stratification by volume, FTR rates increased from high to middle tercile centers (19.3% vs. 23.0%). Multivariate logistic regression models suggested an independent relationship between higher center volume and lower FTR rates (p < 0.001). Conclusion: Higher volume lung transplantation centers have lower rates of failure to rescue.",

keywords = "Failure to rescue, Lung transplantation, Mortality, Surgical quality, Survival",

author = "Osho, {Asishana A.} and Bishawi, {Muath M.} and Heng, {Elbert E.} and Ejiro Orubu and Aaron Amardey-Wellington and Villavicencio, {Mauricio A.} and Masaki Funamoto",

note = "Funding Information: This work was supported in part by Health Resources and Services Administration contract 234-2005-37011C . The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. Funding Information: This work was supported in part by Health Resources and Services Administration contract 234-2005-37011C. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. Publisher Copyright: {\textcopyright} 2020 Elsevier Inc.",

year = "2020",

month = sep,

doi = "10.1016/j.amjsurg.2020.01.020",

language = "English",

volume = "220",

pages = "793--799",

journal = "American Journal of Surgery",

issn = "0002-9610",

publisher = "Elsevier Inc.",

number = "3",

}

TY - JOUR

T1 - Failure to rescue in the era of the lung allocation score

T2 - The impact of center volume

AU - Osho, Asishana A.

AU - Bishawi, Muath M.

AU - Heng, Elbert E.

AU - Orubu, Ejiro

AU - Amardey-Wellington, Aaron

AU - Villavicencio, Mauricio A.

AU - Funamoto, Masaki

N1 - Funding Information: This work was supported in part by Health Resources and Services Administration contract 234-2005-37011C . The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. Funding Information: This work was supported in part by Health Resources and Services Administration contract 234-2005-37011C. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. Publisher Copyright: © 2020 Elsevier Inc.

PY - 2020/9

Y1 - 2020/9

N2 - Background: Failure to Rescue (FTR) is a valuable surgical quality improvement metric. The aim of this study is to assess the relationship between center volume and FTR following lung transplantation. Methods: Using the database of the United Network for Organ Sharing (UNOS) all adult, primary, isolated lung recipients in the United States between May 2005 and March 2016 were identified. FTR was defined as operative mortality after any of five specific complications. FTR was compared across terciles of transplantation centers stratified based on operative volume. Results: 17,185 lung recipients met study criteria. The composite FTR rate (Death following at least one complication) was 20.7%. Following stratification by volume, FTR rates increased from high to middle tercile centers (19.3% vs. 23.0%). Multivariate logistic regression models suggested an independent relationship between higher center volume and lower FTR rates (p < 0.001). Conclusion: Higher volume lung transplantation centers have lower rates of failure to rescue.

AB - Background: Failure to Rescue (FTR) is a valuable surgical quality improvement metric. The aim of this study is to assess the relationship between center volume and FTR following lung transplantation. Methods: Using the database of the United Network for Organ Sharing (UNOS) all adult, primary, isolated lung recipients in the United States between May 2005 and March 2016 were identified. FTR was defined as operative mortality after any of five specific complications. FTR was compared across terciles of transplantation centers stratified based on operative volume. Results: 17,185 lung recipients met study criteria. The composite FTR rate (Death following at least one complication) was 20.7%. Following stratification by volume, FTR rates increased from high to middle tercile centers (19.3% vs. 23.0%). Multivariate logistic regression models suggested an independent relationship between higher center volume and lower FTR rates (p < 0.001). Conclusion: Higher volume lung transplantation centers have lower rates of failure to rescue.

KW - Failure to rescue

KW - Lung transplantation

KW - Mortality

KW - Surgical quality

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=85078135889&partnerID=8YFLogxK

U2 - 10.1016/j.amjsurg.2020.01.020

DO - 10.1016/j.amjsurg.2020.01.020

M3 - Article

C2 - 31982094

AN - SCOPUS:85078135889

SN - 0002-9610

VL - 220

SP - 793

EP - 799

JO - American Journal of Surgery

JF - American Journal of Surgery

IS - 3

ER -

Failure to rescue in the era of the lung allocation score: The impact of center volume

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this