Massachusetts General Hospital, Cardiac Surgery, Cox 6, 55 Fruit Street, Boston, MA, 02114, USA.
Duke University Medical Center, Thoracic Surgery, DUMC Box 3496, Durham, NC, 27710, USA.
Am J Surg. 2020 Sep;220(3):793-799. doi: 10.1016/j.amjsurg.2020.01.020. Epub 2020 Jan 18.
Failure to Rescue (FTR) is a valuable surgical quality improvement metric. The aim of this study is to assess the relationship between center volume and FTR following lung transplantation.
Using the database of the United Network for Organ Sharing (UNOS) all adult, primary, isolated lung recipients in the United States between May 2005 and March 2016 were identified. FTR was defined as operative mortality after any of five specific complications. FTR was compared across terciles of transplantation centers stratified based on operative volume.
17,185 lung recipients met study criteria. The composite FTR rate (Death following at least one complication) was 20.7%. Following stratification by volume, FTR rates increased from high to middle tercile centers (19.3% vs. 23.0%). Multivariate logistic regression models suggested an independent relationship between higher center volume and lower FTR rates (p < 0.001).
Higher volume lung transplantation centers have lower rates of failure to rescue.
抢救失败（FTR）是一项有价值的外科质量改进指标。本研究旨在评估肺移植后中心容量与 FTR 之间的关系。
使用美国器官共享网络（UNOS）数据库，确定 2005 年 5 月至 2016 年 3 月期间美国所有成人、原发性、孤立性肺移植受者。FTR 定义为五种特定并发症之一后的手术死亡率。根据手术量对移植中心进行分层，将 FTR 与三分位数进行比较。
17185 例肺移植受者符合研究标准。复合 FTR 率（至少一种并发症后的死亡）为 20.7%。按体积分层后，FTR 率从中位三分位数中心升高（19.3%比 23.0%）。多变量逻辑回归模型表明，中心容量较高与 FTR 率较低之间存在独立关系（p<0.001）。
大容量肺移植中心抢救失败的发生率较低。
