期刊
JOURNAL OF CLINICAL MEDICINE
卷 11, 期 13, 页码 -出版社
MDPI
DOI: 10.3390/jcm11133806
关键词
transcatheter aortic valve implantation volume-outcome relationship; cost; complications; failure to rescue
Practice is important in complex interventions, as there is a strong relationship between high volume and better outcomes. The complexity of the procedure affects the volume-outcome relationship. Failure to rescue is a factor leading to higher mortality rates after complex surgery. High-volume centers offer a better safety net with improved structure and protocols, while low-volume operators have better results in high-volume centers.
Practice makes perfect is an old saying that can be true for complex interventions. There is a strong and persistent relationship between high volume and better outcomes with more than 300 studies being reported on the subject. The more complex the procedure, the greater the volume-outcome relationship is. Failure to rescue was shown to be one of the factors explaining higher mortality rates post complex surgery. High-volume centers provide a better safety net, thanks to the structure and better protocols, and low-volume operators have better results at high-volume centers than at low-volume centers. Finally, effort should be made to regroup complex procedures in high-volume centers, but without compromising patient access to the procedures. Adaptation to local and geographic constraints is important.
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