Abstract W P278: Relationships Between Hospital Volume and Outcomes in Ischemic and Hemorrhagic Patients: J-aspect Study
Background and Purpose: Mortality and morbidity can be increased in process of some medical training. We aimed to examine relationship between hospital volumes and outcomes in ischemic and hemorrhage stroke.
Methods: We analyzed emergency-hospitalized patients in 147 certified training institutions in Japan. Data between April 1, 2010 and May 31, 2013 was obtained from Japanese Diagnosis Procedure Combination database. The outcome measures were in-hospital mortality and proportion of mRS 0-2 at discharge. Hospital volumes were divided by quartile points and compared with that of lower interquartile range (Q1) as control. Effects of hospital volumes were analyzed using logistic regression model, adjusting age, sex, levels of consciousness on admission and comorbidities.
Results: Of 114,219 emergency-hospitalized patients, 64.1%, 27.9% and 8.2% patients suffered from IS, ICH and SAH, respectively. Table shows proportions of outcomes for each interquartile range of hospital volumes. In-hospital mortality decreased as hospital volumes increased in all subtypes. Proportions of mRS 0-2 at discharge increased as hospital volumes increased in IS and SAH. After adjustment, effects of hospital volumes on mortality were significantly correlated in IS (adjusted OR, 0.89; 95% CI, 0.79-0.99 for upper inter quartile range (Q4) compared with Q1 as control). And effects of hospital volumes on mRS 0-2 at discharge were significantly correlated in SAH (adjusted OR, 1.17; 95% CI, 1.02-1.34 for Q4 compared with Q1 as control) (Figure).
Conclusion: Increasing hospital volumes were significantly correlated with favorable outcomes in ischemic and hemorrhagic stroke.
Author Disclosures: S. Kamitani: None. K. Nishimura: None. A. Kada: None. R. Kurogi: None. A. Nishimura: None. T. Sayama: None. K. Iihara: None.
- © 2015 by American Heart Association, Inc.