Operator volume and outcome of patients undergoing coronary stent placement
Adnan Kastrati, MDa,
Franz-Josef Neumann, MDa and
Albert Schömig, MDa
a Deutsches Herzzentrum and 1. Medizinische Klinik rechts der Isar, Technische Universität München, Munich, Germany
View larger version (19K):
[in a new window]
|
Figure 1 Plot of the risk-adjusted cardiac event rate (death, myocardial infarction or bypass surgery) for different operator volume ranges of stent placement procedures. Data presented as means and 95% confidence intervals. Dotted line shows the event rate for the entire population (2.99%).
|
|
View larger version (8K):
[in a new window]
|
Figure 2 Graph presenting odds ratios and their 95% confidence intervals for independent risk factors for an adverse outcome as identified by multivariate analysis. For operator volume of stenting procedures, the comparison is between 500 and 100 procedures. Odds ratios are displayed on a logarithmic scale.
|
|
View larger version (15K):
[in a new window]
|
Figure 3 Graph presenting the CART model constructed with the independent risk factors for an adverse outcome. The area of a circle is proportional to the size of the subgroup. Numbers within the circles indicate adverse outcome rate in percent for the given subdivision. The analysis identifies at each level two subgroups with a statistically significant difference in adverse outcome rate. The number of operators that contributed to procedures corresponding to the seven terminal nodes of the CART was 8, 9, 10, 3, 3, 10 and 10, respectively (from the left to the right). Pts = patients; Proc. = procedures; LV Func. = left ventricular function. Note the effect of operator volume of stenting procedures on the outcome of patients.
|
|
View larger version (18K):
[in a new window]
|
Figure 4 Plot of the risk-adjusted cardiac event rate (death, myocardial infarction or bypass surgery) for different operator yearly volume ranges of stent placement procedures. Data presented as means and 95% confidence intervals. Dotted line presents the event rate for the entire population (2.99%).
|
|
View larger version (14K):
[in a new window]
|
Figure 5 Graph presenting the CART model constructed with the independent risk factors for cardiac events. The area of a circle is proportional to the size of the subgroup. Numbers within the circles indicate adverse outcome rate in percent for the given subdivision. The analysis identifies at each level two subgroups with a statistically significant difference in adverse outcome rate. The number of operators that contributed to procedures corresponding to the six terminal nodes of the CART was 9, 9, 10, 9, 9 and 9, respectively (from the left to the right). Pts = patients; Proc./Y = procedures per year; LV Func. = left ventricular function. Note the effect of operator yearly volume of stenting procedures on the outcome of patients.
|
|
|
