https://m2.mtmt.hu/ hun 2026-09-20 23:40 JournalArticle 31932586 VALIDATED true University of Florida College of Medicine, Division of Vascular Surgery & Endovascular Therapy, Gainesville, FL, United States Division of Vascular Surgery and Endovascular Therapy, University of Alabama at Birmingham, Birmingham, AL, United States Population Health Sciences, Weill Cornell Medical College, New York, NY, United States Department of Vascular Medicine, Working Group GermanVasc, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany Cambridge Vascular Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom Department of Vascular Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland Division of Vascular Surgery, University of Minnesota, Minneapolis, MN, United States Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Centre, Boston, MA, United States Australasian Vascular Audit, Australasian Society for Vascular Surgery, Melbourne, Australia Department of Vascular Surgery, Semmelweis University, Budapest, Hungary Department of Vascular Surgery, Rigshospitalet, Copenhagen University, Copenhagen, Denmark Department of Surgery, University of Otago, Dunedin, New Zealand Department of Surgery, Faculty of Medicine and Surgery, University of Malta, Malta Department of Vascular Surgery, St. Olavs Hospital, Trondheim, Norway The Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, United Kingdom Department of Surgical Sciences, Uppsala University, Uppsala, Sweden Section of Vascular Surgery, Dartmouth-Hitchcock Medical Centre, Lebanon, NH, United States Cited By :10 Export Date: 21 February 2022 CODEN: EJVSF Correspondence Address: Scali, S.T.; Division of Vascular Surgery and Endovascular Therapy, P.O. Box 100128, Suite NG-45, 1600 SW Archer Rd, United States; email: salvatore.scali@surgery.ufl.edu 0 false 2026-07-23T11:21:13.371+0000 2024-11-04T11:28:09.344+0000 2021-03-26T09:53:19.902+0000 true 10074913 Sághi-Keszthelyi Anna /api/admin/10074913 Admin true 2024-12-19T12:57:48.077+0000 2024-11-04T11:28:09.651+0000 true 10069305 Kondor Zóra /api/admin/10069305 Admin true true false true 24 24 /api/publicationtype/24 PublicationType 1 true 24 JournalArticle true 10000059 Article true 24 24 /api/publicationtype/24 PublicationType 1 true 24 JournalArticle /api/subtype/10000059 Szakcikk SubType 101 true 10000059 true 1 /api/category/1 Category true 1 Scali, S.T. Editor's Choice – Optimal Threshold for the Volume–Outcome Relationship After Open AAA Repair in the Endovascular Era: Analysis of the International Consortium of Vascular Registries true true /api/journal/7477 REVIEWED true false 7477 false 7477 true 1078-5884 1532-2165 Journal FOREIGN 61 5 747 755 747 9 2021 Objective: As open abdominal aortic aneurysm (AAA) repair (OAR) rates decline in the endovascular era, the endorsement of minimum volume thresholds for OAR is increasingly controversial, as this may affect credentialing and training. The purpose of this analysis was to identify an optimal centre volume threshold that is associated with the most significant mortality reduction after OAR, and to determine how this reflects contemporary practice. Methods: This was an observational study of OARs performed in 11 countries (2010 – 2016) within the International Consortium of Vascular Registry database (n = 178 302). The primary endpoint was post-operative in hospital mortality. Two different methodologies (area under the receiving operating curve optimisation and Markov chain Monte Carlo procedure) were used to determine the optimal centre volume threshold associated with the most significant mortality improvement. Results: In total, 154 912 (86.9%) intact and 23 390 (13.1%) ruptured AAAs were analysed. The majority (63.1%; n = 112 557) underwent endovascular repair (EVAR) (OAR 36.9%; n = 65 745). A significant inverse relationship between increasing centre volume and lower peri-operative mortality after intact and ruptured OAR was evident (p < .001) but not with EVAR. An annual centre volume of between 13 and 16 procedures per year was associated with the most significant mortality reduction after intact OAR (adjusted predicted mortality < 13 procedures/year 4.6% [95% confidence interval 4.0% – 5.2%] vs. ≥ 13 procedures/year 3.1% [95% CI 2.8% – 3.5%]). With the increasing adoption of EVAR, the mean number of OARs per centre (intact + ruptured) decreased significantly (2010 – 2013 = 35.7; 2014 – 2016 = 29.8; p < .001). Only 23% of centres (n = 240/1 065) met the ≥ 13 procedures/year volume threshold, with significant variation between nations (Germany 11%; Denmark 100%). Conclusion: An annual centre volume of 13 – 16 OARs per year is the optimal threshold associated with the greatest mortality risk reduction after treatment of intact AAA. However, in the current endovascular era, achieving this threshold requires significant re-organisation of OAR practice delivery in many countries, and would affect provision of non-elective aortic services. Low volume centres continuing to offer OAR should aim to achieve mortality results equivalent to the high volume institution benchmark, using validated data from quality registries to track outcomes. © 2021 European Society for Vascular Surgery true true 2021 true true true false true false GOLD 2026-07-23 true https://doi.org/10.1016/j.ejvs.2021.02.018 55 0 55 32 1 54 55 49 52 53 53 30 30 32 23 0 55 32 55 32 0 5 5 Folyóiratcikk Journal Article 24 55 Könyvrészlet Chapter in Book 25 0 Könyv Book 23 0 Egyéb konferenciaközlemény Conference paper 31 0 Egyéb konferenciakötet Conference proceedings 32 0 Oltalmi formák Protection forms 26 0 Disszertáció Thesis 28 0 Egyéb Miscellaneous 29 0 Alkotás Achievement 22 0 Kutatási adat Research data 33 0 Folyóiratcikk Journal Article 24 0 0 0 Könyvrészlet Chapter in Book 25 0 0 0 Könyv Book 23 0 0 0 Egyéb konferenciaközlemény Conference paper 31 0 0 0 Egyéb konferenciakötet Conference proceedings 32 0 0 0 Oltalmi formák Protection forms 26 0 0 0 Disszertáció Thesis 28 0 0 0 Egyéb Miscellaneous 29 0 0 0 Alkotás Achievement 22 0 0 0 Kutatási adat Research data 33 0 0 0 2021 0 6 3 6 3 2022 0 16 12 16 12 2023 0 5 3 5 3 2024 0 12 6 12 6 2025 0 4 2 4 2 2026 0 12 6 12 6 D1 false false false false 2021-06-19T09:46:28.242+0000 Érsebészeti és Endovaszkuláris Tanszék (SE / AOK / K) 1 13 1 20 0 true Language 10002 /api/language/10002 Angol English true 2 true PersonAuthorship 95791375 /api/authorship/95791375 1 0.05 true false true Scali S.T. true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 95791376 /api/authorship/95791376 2 0.05 false false false Beck A. true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 95791377 /api/authorship/95791377 3 0.05 false false false Sedrakyan A. true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 95791378 /api/authorship/95791378 4 0.05 false false false Mao J. true 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Beiles B. true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 95791385 /api/authorship/95791385 11 0.05 false false false Author 10025764 /api/author/10025764 Szeberin Zoltán true 10025764 true Szeberin Z. true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 95791386 /api/authorship/95791386 12 0.05 false false false Eldrup N. true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 95791387 /api/authorship/95791387 13 0.05 false false false Thomson I. true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 95791388 /api/authorship/95791388 14 0.05 false false false Cassar K. true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true false true PersonAuthorship 95791389 /api/authorship/95791389 15 0.05 false false false Altreuther M. true false false AuthorshipType 1 /api/authorshiptype/1 0 true 0 true 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autype0"> <span class="author-name" >Scali S.T. ✉ </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Beck A. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Sedrakyan A. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Mao J. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Behrendt C.-A. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Boyle J.R. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Venermo M. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Faizer R. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Schermerhorn M. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Beiles B. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" mtid="10025764"><a href="/gui2/?type=authors&mode=browse&sel=10025764" target="_blank">Szeberin Z. (<span class="authorship-author-name">Szeberin Zoltán</span> <span class="authorAux-mtmt"> Érsebészet</span>) </a> </span> <span class="author-affil"><span title="Semmelweis Egyetem">SE</span>/<span title="Általános Orvostudományi Kar">AOK</span>/<span title="Klinikum">K</span>/<span title="Városmajori Szív- és Érgyógyászati Klinika">VAROSMAJOR_SZÍVÉRGYÓGY</span>/Érsebészeti és Endovaszkuláris Tanszék</span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Eldrup N. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Thomson I. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Cassar K. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Altreuther M. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Debus S. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Johal A. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Bjorck M. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Cronenwett J.L. </span> ;&nbsp;&nbsp;&nbsp; <span class="author-name" >Mani K. </span> </div> </div> <div class="title"><a href="/gui2/?mode=browse&params=publication;31932586" target="_blank">Editor's Choice – Optimal Threshold for the Volume–Outcome Relationship After Open AAA Repair in the Endovascular Era: Analysis of the International Consortium of Vascular Registries</a></div> <div> <span class="journal-title">EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY</span> <span class="journal-issn">(<a target="_blank" href="https://portal.issn.org/resource/ISSN/1078-5884">1078-5884</a> <a target="_blank" href="https://portal.issn.org/resource/ISSN/1532-2165">1532-2165</a>)</span>: <span class="journal-volume">61</span> <span class="journal-issue">5</span> <span class="page"> pp 747-755 </span> <span class="year">(2021)</span> </div> <div class="pub-footer"> <span class="language" xmlns="http://www.w3.org/1999/html">Nyelv: Angol | </span> <span class="identifiers"> <span class="id identifier oa_GOLD" title=" Gold "> <a style="color:blue" title="10.1016/j.ejvs.2021.02.018" target="_blank" href="https://doi.org/10.1016/j.ejvs.2021.02.018"> DOI </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="000652595500006" target="_blank" href="https://www.webofscience.com/wos/woscc/full-record/000652595500006"> WoS </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="85102444400" target="_blank" href="http://www.scopus.com/record/display.url?origin=inward&eid=2-s2.0-85102444400"> Scopus </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="33722485" target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=33722485&dopt=Abstract"> PubMed </a> </span> </span> <OnlyViewableByAuthor><div class="ratings"> <div class="journal-subject">Folyóirat szakterülete: Scopus - Surgery&nbsp;&nbsp;&nbsp;SJR indikátor:&nbsp;D1</div> <div class="journal-subject">Folyóirat szakterülete: Scopus - Cardiology and Cardiovascular Medicine&nbsp;&nbsp;&nbsp;SJR indikátor:&nbsp;Q1</div> </div></OnlyViewableByAuthor> <div class="publication-citation" style="margin-left: 0.5cm;"> <span title="Nyilvános idézőközlemények összesen, említések nélkül" class="citingPub-count">Nyilvános idéző összesen: 55</span> | Független: 32 | Függő: 23 | Nem jelölt: 0 | WoS jelölt: 49 | Scopus jelölt:&nbsp;52 | WoS/Scopus jelölt:&nbsp;53 | DOI jelölt:&nbsp;55 </div> <div class="publication-citation"> <a target="_blank" href="/api/publication?cond=citations.related;eq;31932586&sort=publishedYear,desc&sort=title"> Idézett közlemények száma: 5 </a> </div> <div class="mtid"><span class="long-pub-mtid">Közlemény: 31932586</span> | <span class="status-data status-VALIDATED"> Egyeztetett </span> Forrás Idéző | <span class="type-subtype">Folyóiratcikk ( Szakcikk ) </span> | <span class="pub-category">Tudományos</span> | <span class="publication-sourceOfData">Scopus</span> </div> <div class="lastModified">Utolsó módosítás: 2024.11.04. 12:28 Kondor Zóra (SE_KK_Admin5_KZ, admin) </div> <pre class="comment" style="margin-top: 0; margin-bottom: 0;"><u>Megjegyzés</u>: University of Florida College of Medicine, Division of Vascular Surgery & Endovascular Therapy, Gainesville, FL, United States Division of Vascular Surgery and Endovascular Therapy, University of Alabama at Birmingham, Birmingham, AL, United States Population Health Sciences, Weill Cornell Medical College, New York, NY, United States ...</pre> </div></div>