US News investigates low-volume congenital heart surgery programs: 6 key findings

One in 4 deaths that occur following complex congenital heart surgeries could be avoided if the surgeries were performed at high-volume hospitals, according to a U.S. News & World Report analysis released Wednesday.

U.S. News completed an analysis of 4,000 complex congenital heart surgeries with the Johns Hopkins Medicine's Armstrong Institute for Patient Safety and Quality in Baltimore. The surgeries were performed at 61 hospitals from 2012 to 2015.

Here are six things to know about the findings.

1. Researchers used definitions from the Society of Thoracic Surgeons to set volume thresholds: low-volume programs treated an average of fewer than 100 patients per year, medium-volume programs saw 100 to 249 such patients annually and high-volume programs saw 250 or more patients each year.

2. Out of 4,000 completed surgeries, 395 patients died.

3. Of those 395 deaths, 104 (26 percent) could have been avoided if the operations were completed in hospitals where 250 or more of such surgeries are performed. See the methodology here.

4. Of the 61 hospitals included in the analysis, nine treated two or fewer of such surgeries annually.

5. More deaths occurred in medium-volume hospitals than in low-volume hospitals — 82 patients died in medium-volume centers and 22 died in low-volume centers.

6. "Safety continues to lie in numbers, and our analysis reveals a constant pattern of more preventable deaths occurring at low-volume and mid-size hospitals versus high-volume centers," said Steve Sternberg, a senior writer with U.S. News.

This is not the first time higher volume has been linked to better outcomes for surgical patients. A 2015 analysis from U.S. News & World Report found risk of patient harm to be high at low-volume hospitals, and a study published in May in JAMA Surgery found very low-volume surgeons can put patients at risk for complications.

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