Evidence map›Paper›PMID 39206731›Full record

ArticleEuropean journal of heart failure2024

Association between caseload volume and outcomes in left ventricular assist device implantations - a EUROMACS analysis.

Maks Mihalj, David Reineke, Isabell A Just, Johanna Mulzer, Nikolaos Cholevas, Christoph Hoermandinger, Kevin Veen, Markus M Luedi, Paul Philipp Heinisch, Evgenij Potapov and 12 more

Abstract readMulticenter Study
In one paragraph

Article in European journal of heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Maks MihaljDepartment of Cardiac Surgery, University Hospital Bern, University of Bern, Bern, Switzerland.ORCID https://orcid.org/0000-0002-6298-7985
David ReinekeDepartment of Cardiac Surgery, University Hospital Bern, University of Bern, Bern, Switzerland.
Isabell A JustDepartment of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany.
Johanna MulzerDepartment of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany.
Nikolaos CholevasDepartment of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany.
Christoph HoermandingerDepartment of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany.
Kevin VeenDepartment of Cardiothoracic Surgery, Erasmus MC, Rotterdam, The Netherlands.
Markus M LuediDepartment of Anaesthesiology, Emergency Medicine and Pain Medicine, Cantonal University Hospital St. Gallen, University of St. Gallen, St. Gallen, Switzerland.
Paul Philipp HeinischDepartment of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technical University Munich, Munich, Germany.
Evgenij PotapovDepartment of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany.
Jan F GummertDepartment for Thoracic and Cardiovascular Surgery, Heart and Diabetes Centre NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany.
Paul MohacsiHerz-Gefäss-Zentrum im Park, Zurich, Switzerland.
Christian HaglDepartment of Cardiac Surgery, University Hospital of Munich, Ludwig-Maximillians-University, Munich, Germany.
Gloria FaerberDepartment of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany.
Daniel ZimpferDepartment of Cardiothoracic Surgery, Medical University of Vienna, Vienna, Austria.
Theo M M H de ByEACTS House, Windsor, UK.
Bart MeynsDepartment of Cardiac Surgery, University Hospital Leuven, Leuven, Belgium.
Finn GustafssonDepartment of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Lukas HunzikerDivision of Heart Failure, Department of Cardiology, University Hospital Bern, University of Bern, Bern, Switzerland.
Matthias SiepeDepartment of Cardiac Surgery, University Hospital Bern, University of Bern, Bern, Switzerland.
Patrick Schober *Department of Anaesthesiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Felix Schoenrath *Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany.ORCID https://orcid.org/0000-0002-8221-1295

Funding

European Association for Cardio-Thoracic Surgery
6 · The paper itself

Abstract

aimsThis EUROMACS study was conducted with the primary aim of investigating the association between a centre's annual caseload and postoperative outcomes among patients undergoing left ventricular assist device (LVAD) implantation. METHODS AND

resultsA total of 4802 patients identified between 2011 and 2020 from 35 participating centres were dichotomized based on the annual caseload of the treating centre at the time of device implant (≤30 vs. >30 LVAD implantations/year). The primary endpoint was 1-year survival. Secondary outcomes included overall survival analysis, device-related adverse events and readmissions. Cumulative follow-up was 10 003 patient-years, with a median follow-up of 1.54 years (interquartile range 0.52-3.15). Patients from higher volume centres more frequently presented in INTERMACS levels 1 and 2, suffered from right heart dysfunction and needed inotropic support. No difference was observed in adjusted 1-year survival. Adjusted overall survival probability was lower in higher volume centres (p = 0.002). In the subgroup analysis of HeartMate 3 devices only, higher volume centres were associated with decreased odds of 1-year survival (adjusted odds ratio 0.43, 95% confidence interval 0.20-0.97, p = 0.041). Similar findings were observed in the cumulative (i.e. learning curve) caseload analyses.

conclusionIn patients undergoing LVAD implantation, centre volume was not associated with 1-year survival, but was related to device-related adverse events. Patient profiles differed with respect to centre size. These findings underscore the necessity for ongoing quality improvement initiatives in all centres, regardless of their annual caseload. Efforts are needed to standardize patient selection and preconditioning to further improve patient outcome.

Indexed as

Heart-Assist DevicesHeart FailureAgedEuropeFemaleFollow-Up StudiesHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesSurvival RateTreatment OutcomeAnnual caseloadCentre volumeClinical outcomesCumulative caseloadLearning curveLeft ventricular assist device

Identifiers

PMID39206731
PMCPMC11659493

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Registered trials

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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.