SynthesisChest2015
The Volume-Outcome Relationship in Critical Care: A Systematic Review and Meta-analysis.
Synthesis in Chest, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
75 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Pooled it
- The impact of telehealth in sepsis care: A systematic review.Journal of telemedicine and telecare · 2025Pooled it
- Mortality factors in pancreatic surgery: A systematic review. How important is the hospital volume?International journal of surgery (London, England) · 2022Pooled it
- The Role of Physician and Practice Characteristics in the Quality of Diabetes Management in Primary Care: Systematic Review and Meta-analysis.Journal of general internal medicine · 2020Pooled it
- Impacts of mandatory clinical ethics consultation on resource utilization and ethical conflicts in critically ill patients: a comparison between medical and surgical intensive care units.BMC medical ethics · 2025Trial
- Trends in Regionalization of Pediatric Inpatient and Critical Care by Medical Complexity.Hospital pediatrics · 2026Article
- Impact of Mandatory Clinical Ethics Consultation for Neurocritically Ill Patients.Journal of bioethical inquiry · 2026Article
- Article
- The association between interhospital transfer and sepsis guideline adherence among rural emergency department patients.PloS one · 2026Article
- Intensive Care Unit Admissions Purchased or Delivered by Veterans in the VA Health Care System.JAMA health forum · 2025Article
- Hospital volume-outcome relationship in emergency trunk interventional radiology for trauma patients: a nationwide observational study in Japan.European radiology · 2025Observational
- Association of Intensive Care Unit Patient-to-Clinician Ratios with Mortality across Two U.S. Health Systems.Annals of the American Thoracic Society · 2025Article
- Health Insurance and Interhospital Transfer for Critically Ill Patients With Respiratory Failure.JAMA network open · 2025Article
- Association of mortality and physician experience in prehospital anaesthesia: a registry study on new physicians in Finnish helicopter emergency medical services.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Observational
- Impact of overall major oncologic surgery volume on outcomes in esophagogastrectomies with intrathoracic anastomosis.Langenbeck's archives of surgery · 2025Article
- Association between hospital case volume and mortality in pediatric sepsis: A retrospective observational study using a Japanese nationwide inpatient database.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2025Article
- The Impact of Hospital Delivery Volumes of Newborns Born Very Preterm on Mortality and Morbidity.The Journal of pediatrics · 2025Observational
- Be-SNAP: the Belgian Sepsis National Action Plan.Frontiers in public health · 2025Article
- Intensive care unit caseload and workload and their association with outcomes in critically unwell patients: a large registry-based cohort analysis.Critical care (London, England) · 2024Article
- Overall Volume of Upper Gastrointestinal Surgery Positively Impacts Gastric Cancer Outcomes at Centers with Low Gastrectomy Volume.Annals of surgical oncology · 2024Article
15 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
objectiveThe purpose of this study was to systematically review the research on volume and outcome relationships in critical care.
methodsFrom January 1, 2001, to April 30, 2014, MEDLINE and EMBASE were searched for studies assessing the relationship between admission volume and clinical outcomes in critical illness. Bibliographies were reviewed to identify other articles of interest, and experts were contacted about missing or unpublished studies. Of 127 studies reviewed, 46 met inclusion criteria, covering seven clinical conditions. Two investigators independently reviewed each article using a standardized form to abstract information on key study characteristics and results.
resultsOverall, 29 of the studies (63%) reported a statistically significant association between higher admission volume and improved outcomes. The magnitude of the association (mortality OR between the lowest vs highest stratum of volume centers), as well as the thresholds used to characterize high volume, varied across clinical conditions. Critically ill patients with cardiovascular (n = 7, OR = 1.49 [1.11-2.00]), respiratory (n = 12, OR = 1.20 [1.04-1.38]), severe sepsis (n = 4, OR = 1.17 [1.03-1.33]), hepato-GI (n = 3, OR = 1.30 [1.08-1.78]), neurologic (n = 3, OR = 1.38 [1.22-1.57]), and postoperative admission diagnoses (n = 3, OR = 2.95 [1.05-8.30]) were more likely to benefit from admission to higher-volume centers compared with lower-volume centers. Studies that controlled for ICU or hospital organizational factors were less likely to find a significant volume-outcome relationship than studies that did not control for these factors.
conclusionsCritically ill patients generally benefit from care in high-volume centers, with more substantial benefits in selected high-risk conditions. This relationship may in part be mediated by specific ICU and hospital organizational factors.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.