ArticlePloS one2023
Teaching hospitals and their influence on survival after valve replacement procedures: A retrospective cohort study using inverse probability of treatment weighting (IPTW).
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 9 citations in OpenAlex.
- Impact of Operating Room Efficiencies on Patient Outcomes Following Primary Coronary Artery Bypass Surgery.Interdisciplinary cardiovascular and thoracic surgery · 2026Article
- Mortality and comorbidities among teaching professionals: A cross-sectional study in Colombia.PloS one · 2026Article
- Cost-effectiveness of rapid-deployment aortic valve replacement over TAVI: a real-world retrospective cohort study.Journal of cardiothoracic surgery · 2025Article
- Prevalence, comorbidities, and disease-related complications of rheumatoid arthritis in Colombia: a national cross-sectional study based on administrative claims data.Advances in rheumatology (London, England) · 2025Observational
- Association of healthcare fragmentation with three-year survival among kidney transplant recipients in Colombia.PloS one · 2025Article
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe effect of teaching hospital status on cardiovascular surgery has been of common interest in recent decades, yet its magnitude on heart valve replacement is still a matter of debate. Given the ethical and practical unfeasibility of randomly assigning a patient to such an exposure, we use the inverse probability of treatment weighting (IPTW) to assess this marginal effect on the survival of Colombian patients who underwent a first heart valve replacement between 2016 and 2019.
methodsA retrospective cohort study was conducted based on administrative records. The time-to-death event and cumulative incidences of death, readmission, and reoperation are presented as outcomes. An artificial sample is configured through IPTW, adjusting for sociodemographic variables, comorbidities, technique, and intervention weight.
resultsOf a sample of 3,517 patients, 1,051 (29.9%) were operated on in a teaching hospital. The median age was 65.0 (18.1-91.5), 38.5% of patients were ≤60, and 6.9% were ≥80. The cumulative incidences of death at 30, 90 days, and one year were 5.9%, 8%, and 10.9%, respectively. Furthermore, 23.5% of the patients were readmitted within 90 days and 3.6% underwent reintervention within one year. The odds of 30-day mortality are lower for patients operated in a teaching hospital (OR 0.51; 95% CI 0.29-0.92); however, no effect on survival was identified in terms of time-to-event of death (HR 1.07; 95%CI 0.78-1.46).
conclusionsAfter IPTW, the odds of 30-day mortality are lower for patients operated in a teaching hospital. There was no effect on survival, 90-day or one-year mortality, 90-day readmission, or one-year reintervention. Together, we offer an opening for investigating an exposure that has yet to be explored in Latin America with potential value to understand teaching hospitals as the essential nature of reality of an academic-clinical synergy.
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