Hospital Volume Counts for Ruptured Abdominal Aortic Aneurysm Repair: Evolving Data from a Meta-Analysis

Abstract

Kontopodis et al.1 provide a contemporary perspective on the volume outcome relationship with ruptured abdominal aortic aneurysm (AAA) repair. To date, several publications have examined centre and surgeon volume association with both elective and non-elective AAA repair outcomes. The importance of this issue is underscored by the fact that professional societies and watchdog organisations endorse specific and often conflicting volume thresholds for elective repair, presumptively to serve as proxies for high quality care, without recommendations for ruptured presentations (European Society for Vascular Surgery: surgeon ≥ 10, centre ≥ 30 procedures/year; International Consortium of Vascular Registries: surgeon not applicable, centre ≥ 13–16; Society for Vascular Surgery: surgeon not applicable, centre ≥ 10; Leapfrog Group: surgeon ≥ 10, centre ≥ 15).