Skip to main content
Top
Published in: Journal of Cardiothoracic Surgery 1/2019

Open Access 01-12-2019 | Idiopathic Pulmonary Fibrosis | Research article

Adult lung transplantation case-volume and in-hospital and long-term mortality in Korea

Authors: Susie Yoon, Eun Jin Jang, Ga Hee Kim, Dal Ho Kim, Tae-Yoon Lim, Hannah Lee, Ho Geol Ryu

Published in: Journal of Cardiothoracic Surgery | Issue 1/2019

Login to get access

Abstract

Background

The inverse relationship between case-volume and surgical mortality has been reported in complex surgical procedures. The aim of this study was to evaluate the effect of case-volume on mortality after lung transplantation in Korea.

Methods

The National Health Insurance Service data was used to analyse all adult lung transplantations in Korea between 2007 and 2016. Institutions were categorized into low-volume (< 5 lung transplantations/year) centers or high-volume (≥ 5 lung transplantations/year) centers. Risk-adjusted in-hospital mortality and long-term survival according to case-volume was evaluated.

Results

A total of 315 adult recipients underwent lung transplantation at 7 centers. The odds ratio for in-hospital mortality in low-volume centers was similar to high-volume centers (OR, 1.496; 95% CI, 0.81–2.76; p = 0.197). Log-rank analysis of Kaplan-Meier curves according to case-volume also did not show a difference in long-term survival between high- and low-volume centers (p = 0.052).

Conclusions

There was no association between case-volume and in-hospital mortality after lung transplantation in Korea, although there was a tendency towards better long-term survival associated with high-volume centers.
Literature
1.
go back to reference Hartert M, Senbaklavaci O, Gohrbandt B, Fischer BM, Buhl R, Vahl CF. Lung Transplantation: a Treatment Option in End-Stage Lung Disease. Dtsch Arztebl Int. 2014;111:107–U28.PubMedPubMedCentral Hartert M, Senbaklavaci O, Gohrbandt B, Fischer BM, Buhl R, Vahl CF. Lung Transplantation: a Treatment Option in End-Stage Lung Disease. Dtsch Arztebl Int. 2014;111:107–U28.PubMedPubMedCentral
2.
go back to reference Hayanga JA, Lira A, Vlahu T, D'Cunha J, Hayanga HK, Girgis R, et al. Procedural volume and survival after lung transplantation in the United States: the need to look beyond volume in the establishment of quality metrics. Am J Surg. 2016;211:671–6.CrossRef Hayanga JA, Lira A, Vlahu T, D'Cunha J, Hayanga HK, Girgis R, et al. Procedural volume and survival after lung transplantation in the United States: the need to look beyond volume in the establishment of quality metrics. Am J Surg. 2016;211:671–6.CrossRef
3.
go back to reference Chambers DC, Yusen RD, Cherikh WS, Goldfarb SB, Kucheryavaya AY, Khusch K, et al. The registry of the International Society for Heart and Lung Transplantation: thirty-fourth adult lung and heart-lung transplantation report—2017; focus theme: allograft ischemic time. J Heart Lung Transplant. 2017;36:1047–59.CrossRef Chambers DC, Yusen RD, Cherikh WS, Goldfarb SB, Kucheryavaya AY, Khusch K, et al. The registry of the International Society for Heart and Lung Transplantation: thirty-fourth adult lung and heart-lung transplantation report—2017; focus theme: allograft ischemic time. J Heart Lung Transplant. 2017;36:1047–59.CrossRef
4.
go back to reference Paik HC. Current perspective of lung transplantation. J Korean Med Assoc. 2016;59:119–24.CrossRef Paik HC. Current perspective of lung transplantation. J Korean Med Assoc. 2016;59:119–24.CrossRef
5.
go back to reference Birkmeyer JD, Sun Y, Goldfaden A, Birkmeyer NJ, Stukel TA. Volume and process of care in high-risk cancer surgery. Cancer. 2006;106:2476–81.CrossRef Birkmeyer JD, Sun Y, Goldfaden A, Birkmeyer NJ, Stukel TA. Volume and process of care in high-risk cancer surgery. Cancer. 2006;106:2476–81.CrossRef
6.
go back to reference Cheung MC, Koniaris LG, Perez EA, Molina MA, Goodwin WJ, Salloum RM. Impact of hospital volume on surgical outcome for head and neck Cancer. Ann Surg Oncol. 2009;16:1001–9.CrossRef Cheung MC, Koniaris LG, Perez EA, Molina MA, Goodwin WJ, Salloum RM. Impact of hospital volume on surgical outcome for head and neck Cancer. Ann Surg Oncol. 2009;16:1001–9.CrossRef
7.
go back to reference Checchia PA, McCollegan J, Daher N, Kolovos N, Levy F, Markovitz B. The effect of surgical case volume on outcome after the Norwood procedure. J Thorac Cardiovasc Surg. 2005;129:754–9.CrossRef Checchia PA, McCollegan J, Daher N, Kolovos N, Levy F, Markovitz B. The effect of surgical case volume on outcome after the Norwood procedure. J Thorac Cardiovasc Surg. 2005;129:754–9.CrossRef
8.
go back to reference Gonzalez AA, Dimick JB, Birkmeyer JD, Ghaferi AA. Understanding the volume-outcome effect in cardiovascular surgery: the role of failure to rescue. JAMA Surg. 2014;149:119–23.CrossRef Gonzalez AA, Dimick JB, Birkmeyer JD, Ghaferi AA. Understanding the volume-outcome effect in cardiovascular surgery: the role of failure to rescue. JAMA Surg. 2014;149:119–23.CrossRef
9.
go back to reference Merlo AE, Chauhan D, Pettit C, Hong KN, Saunders CR, Chen C, et al. Outcomes following emergent open repair for thoracic aortic dissection are improved at higher volume centers in direct admissions and transfers. J Cardiothorac Surg. 2016;11(1):118.CrossRef Merlo AE, Chauhan D, Pettit C, Hong KN, Saunders CR, Chen C, et al. Outcomes following emergent open repair for thoracic aortic dissection are improved at higher volume centers in direct admissions and transfers. J Cardiothorac Surg. 2016;11(1):118.CrossRef
10.
go back to reference Edwards EB, Roberts JP, McBride MA, Schulak JA, Hunsicker LG. The effect of the volume of procedures at transplantation centers on mortality after liver transplantation. N Engl J Med. 1999;341:2049–53.CrossRef Edwards EB, Roberts JP, McBride MA, Schulak JA, Hunsicker LG. The effect of the volume of procedures at transplantation centers on mortality after liver transplantation. N Engl J Med. 1999;341:2049–53.CrossRef
11.
go back to reference Macomber CW, Shaw JJ, Santry H, Saidi RF, Jabbour N, Tseng JF, et al. Centre volume and resource consumption in liver transplantation. HPB. 2012;14:554–9.CrossRef Macomber CW, Shaw JJ, Santry H, Saidi RF, Jabbour N, Tseng JF, et al. Centre volume and resource consumption in liver transplantation. HPB. 2012;14:554–9.CrossRef
12.
go back to reference Kilic A, George TJ, Beaty CA, Merlo CA, Conte JV, Shah AS. The effect of center volume on the incidence of postoperative complications and their impact on survival after lung transplantation. J Thorac Cardiovasc Surg. 2012;144:1502–9.CrossRef Kilic A, George TJ, Beaty CA, Merlo CA, Conte JV, Shah AS. The effect of center volume on the incidence of postoperative complications and their impact on survival after lung transplantation. J Thorac Cardiovasc Surg. 2012;144:1502–9.CrossRef
13.
go back to reference Scarborough JE, Bennett KM, Davis RD, Lin SS, Tracy ET, Kuo PC, et al. Temporal trends in lung transplant center volume and outcomes in the United States. Transplantation. 2010;89:639–43.CrossRef Scarborough JE, Bennett KM, Davis RD, Lin SS, Tracy ET, Kuo PC, et al. Temporal trends in lung transplant center volume and outcomes in the United States. Transplantation. 2010;89:639–43.CrossRef
14.
go back to reference Thabut G, Christie JD, Kremers WK, Fournier M, Halpern SD. Survival differences following lung transplantation among US transplant centers. JAMA. 2010;304:53–60.CrossRef Thabut G, Christie JD, Kremers WK, Fournier M, Halpern SD. Survival differences following lung transplantation among US transplant centers. JAMA. 2010;304:53–60.CrossRef
15.
go back to reference Weiss ES, Allen JG, Meguid RA, Patel ND, Merlo CA, Orens JB, et al. The impact of center volume on survival in lung transplantation: an analysis of more than 10,000 cases. Ann Thorac Surg. 2009;88:1062–70.CrossRef Weiss ES, Allen JG, Meguid RA, Patel ND, Merlo CA, Orens JB, et al. The impact of center volume on survival in lung transplantation: an analysis of more than 10,000 cases. Ann Thorac Surg. 2009;88:1062–70.CrossRef
16.
go back to reference Moon TJ. Light and shadows of the Korean healthcare system. J Korean Med Sci. 2012;27:S3–6.CrossRef Moon TJ. Light and shadows of the Korean healthcare system. J Korean Med Sci. 2012;27:S3–6.CrossRef
17.
go back to reference Song SO, Jung CH, Song YD, Park C-Y, Kwon H-S, Cha BS, et al. Background and data configuration process of a nationwide population-based study using the Korean National Health Insurance System. Diabetes Metab J. 2014;38:395–403.CrossRef Song SO, Jung CH, Song YD, Park C-Y, Kwon H-S, Cha BS, et al. Background and data configuration process of a nationwide population-based study using the Korean National Health Insurance System. Diabetes Metab J. 2014;38:395–403.CrossRef
18.
go back to reference Quan H, Sundararajan V, Halfon P, Fong A, Burnand B, Luthi J-C, et al. Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care. 2005;43(11):1130–9.CrossRef Quan H, Sundararajan V, Halfon P, Fong A, Burnand B, Luthi J-C, et al. Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care. 2005;43(11):1130–9.CrossRef
19.
go back to reference Elixhauser A, Steiner C, Harris DR, Coffey RM. Comorbidity measures for use with administrative data. Med Care. 1998;36:8–27.CrossRef Elixhauser A, Steiner C, Harris DR, Coffey RM. Comorbidity measures for use with administrative data. Med Care. 1998;36:8–27.CrossRef
20.
go back to reference Axelrod DA, Guidinger MK, McCullough KP, Leichtman AB, Punch JD, Merion RM. Association of center volume with outcome after liver and kidney transplantation. Am J Transplant. 2004;4:920–7.CrossRef Axelrod DA, Guidinger MK, McCullough KP, Leichtman AB, Punch JD, Merion RM. Association of center volume with outcome after liver and kidney transplantation. Am J Transplant. 2004;4:920–7.CrossRef
21.
go back to reference Weiss ES, Meguid RA, Patel ND, Russell SD, Shah AS, Baumgartner WA, et al. Increased mortality at low-volume orthotopic heart transplantation centers: should current standards change? Ann Thorac Surg. 2008;86:1250–60.CrossRef Weiss ES, Meguid RA, Patel ND, Russell SD, Shah AS, Baumgartner WA, et al. Increased mortality at low-volume orthotopic heart transplantation centers: should current standards change? Ann Thorac Surg. 2008;86:1250–60.CrossRef
22.
go back to reference Kistler KD, Nalysnyk L, Rotella P, Esser D. Lung transplantation in idiopathic pulmonary fibrosis: a systematic review of the literature. BMC Pulm Med. 2014;14:139.CrossRef Kistler KD, Nalysnyk L, Rotella P, Esser D. Lung transplantation in idiopathic pulmonary fibrosis: a systematic review of the literature. BMC Pulm Med. 2014;14:139.CrossRef
23.
go back to reference Chen H, Shiboski SC, Golden JA, Gould MK, Hays SR, Hoopes CW, et al. Impact of the lung allocation score on lung transplantation for pulmonary arterial hypertension. Am J Respir Crit Care Med. 2009;180:468–74.CrossRef Chen H, Shiboski SC, Golden JA, Gould MK, Hays SR, Hoopes CW, et al. Impact of the lung allocation score on lung transplantation for pulmonary arterial hypertension. Am J Respir Crit Care Med. 2009;180:468–74.CrossRef
24.
go back to reference Paik H, Haam S, Lee D, Yi G, Song S, Kim Y, et al. The fate of patients on the waiting list for lung transplantation in Korean. Transplant Proc. 2012;44:865–9.CrossRef Paik H, Haam S, Lee D, Yi G, Song S, Kim Y, et al. The fate of patients on the waiting list for lung transplantation in Korean. Transplant Proc. 2012;44:865–9.CrossRef
25.
go back to reference Checchia PA, Larsen R, Sehra R, Daher N, Gundry SR, Razzouk AJ, et al. Effect of a selection and postoperative care protocol on survival of infants with hypoplastic left heart syndrome. Ann Thorac Surg. 2004;77:477–83.CrossRef Checchia PA, Larsen R, Sehra R, Daher N, Gundry SR, Razzouk AJ, et al. Effect of a selection and postoperative care protocol on survival of infants with hypoplastic left heart syndrome. Ann Thorac Surg. 2004;77:477–83.CrossRef
26.
go back to reference Kuo EY, Chang Y, Wright CD. Impact of hospital volume on clinical and economic outcomes for esophagectomy. Ann Thorac Surg. 2001;72:1118–24.CrossRef Kuo EY, Chang Y, Wright CD. Impact of hospital volume on clinical and economic outcomes for esophagectomy. Ann Thorac Surg. 2001;72:1118–24.CrossRef
27.
go back to reference Migliore M, Choong CK, Lim E, Goldsmith KA, Ritchie A, Wells FC. A surgeon’s case volume of oesophagectomy for cancer strongly influences the operative mortality rate. Eur J Cardiothorac Surg. 2007;32:375–9.CrossRef Migliore M, Choong CK, Lim E, Goldsmith KA, Ritchie A, Wells FC. A surgeon’s case volume of oesophagectomy for cancer strongly influences the operative mortality rate. Eur J Cardiothorac Surg. 2007;32:375–9.CrossRef
28.
go back to reference Tweddell JS, Hoffman GM, Mussatto KA, Fedderly RT, Berger S, Jaquiss RD, et al. Improved survival of patients undergoing palliation of hypoplastic left heart syndrome: lessons learned from 115 consecutive patients. Circulation. 2002;106:I-82-I-9. Tweddell JS, Hoffman GM, Mussatto KA, Fedderly RT, Berger S, Jaquiss RD, et al. Improved survival of patients undergoing palliation of hypoplastic left heart syndrome: lessons learned from 115 consecutive patients. Circulation. 2002;106:I-82-I-9.
29.
go back to reference Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA. 2002;288:1987–93.CrossRef Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA. 2002;288:1987–93.CrossRef
30.
go back to reference Melania Y, Sue W, Nicole F, Thompson JS. The use and modification of clinical pathways to achieve specific outcomes in bariatric surgery. Am Surg. 2005;71:152–4. Melania Y, Sue W, Nicole F, Thompson JS. The use and modification of clinical pathways to achieve specific outcomes in bariatric surgery. Am Surg. 2005;71:152–4.
31.
go back to reference Smith DL, Elting LS, Learn PA, Raut CP, Mansfield PF. Factors influencing the volume-outcome relationship in gastrectomies: a population-based study. Ann Surg Oncol. 2007;14:1846–52.CrossRef Smith DL, Elting LS, Learn PA, Raut CP, Mansfield PF. Factors influencing the volume-outcome relationship in gastrectomies: a population-based study. Ann Surg Oncol. 2007;14:1846–52.CrossRef
32.
go back to reference Centers for Medicare & Medicaid Services. H. Medicare program; hospital conditions of participation: requirements for approval and re-approval of transplant centers to perform organ transplants. Final rule. Fed Regist. 2007;72:15197. Centers for Medicare & Medicaid Services. H. Medicare program; hospital conditions of participation: requirements for approval and re-approval of transplant centers to perform organ transplants. Final rule. Fed Regist. 2007;72:15197.
33.
go back to reference Brat R, Gaj J, Barta J. Early and mid-term outcomes of the aortic arch surgery: experience from the low-volume Centre. J Cardiothorac Surg. 2015;10:31.CrossRef Brat R, Gaj J, Barta J. Early and mid-term outcomes of the aortic arch surgery: experience from the low-volume Centre. J Cardiothorac Surg. 2015;10:31.CrossRef
34.
go back to reference Shim MS, Jun TG, Yang JH, Park PW, Kang IS, Huh J, et al. Current expectations of the arterial switch operation in a small volume center: a 20-year, single-center experience. J Cardiothorac Surg. 2016;11:34.CrossRef Shim MS, Jun TG, Yang JH, Park PW, Kang IS, Huh J, et al. Current expectations of the arterial switch operation in a small volume center: a 20-year, single-center experience. J Cardiothorac Surg. 2016;11:34.CrossRef
35.
go back to reference Khuri SF, Daley J, Henderson W, Hur K, Hossain M, Soybel D, et al. Relation of surgical volume to outcome in eight common operations: results from the VA National Surgical Quality Improvement Program. Ann Surg. 1999;230:414.CrossRef Khuri SF, Daley J, Henderson W, Hur K, Hossain M, Soybel D, et al. Relation of surgical volume to outcome in eight common operations: results from the VA National Surgical Quality Improvement Program. Ann Surg. 1999;230:414.CrossRef
36.
go back to reference Khuri SF, Henderson WG. The case against volume as a measure of quality of surgical care. World J Surg. 2005;29:1222–9.CrossRef Khuri SF, Henderson WG. The case against volume as a measure of quality of surgical care. World J Surg. 2005;29:1222–9.CrossRef
Metadata
Title
Adult lung transplantation case-volume and in-hospital and long-term mortality in Korea
Authors
Susie Yoon
Eun Jin Jang
Ga Hee Kim
Dal Ho Kim
Tae-Yoon Lim
Hannah Lee
Ho Geol Ryu
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2019
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-019-0849-3

Other articles of this Issue 1/2019

Journal of Cardiothoracic Surgery 1/2019 Go to the issue