Abstract：
BACKGROUND: We sought to explore the relationship between various surgeon-related and hospital-level characteristics and clinical outcomes among patients requiring cardiac surgery.
METHODS: We searched the New York State Cardiac Data Reporting System for all coronary artery bypass grafting (CABG) and valve cases between 2015 and 2017. The data were analyzed without dichotomization.
RESULTS: Among CABG/valve surgeons, case volume was positively correlated with years in practice (P = 0.002) and negatively correlated with risk-adjusted mortality ratio (P = 0.014). For CABG and CABG/valve surgeons, our results showed a negative association between teaching status and case volume (P = 0.002, P = 0.018). Among CABG surgeons, hospital teaching status and presence of cardiothoracic surgery residency were inversely associated with risk-adjusted mortality ratio (P = 0.006, P = 0.029).
CONCLUSIONS: There is a complex relationship between case volume, teaching status, and surgical outcomes suggesting that balance between academics and volume is needed.
METHODS: We searched the New York State Cardiac Data Reporting System for all coronary artery bypass grafting (CABG) and valve cases between 2015 and 2017. The data were analyzed without dichotomization.
RESULTS: Among CABG/valve surgeons, case volume was positively correlated with years in practice (P = 0.002) and negatively correlated with risk-adjusted mortality ratio (P = 0.014). For CABG and CABG/valve surgeons, our results showed a negative association between teaching status and case volume (P = 0.002, P = 0.018). Among CABG surgeons, hospital teaching status and presence of cardiothoracic surgery residency were inversely associated with risk-adjusted mortality ratio (P = 0.006, P = 0.029).
CONCLUSIONS: There is a complex relationship between case volume, teaching status, and surgical outcomes suggesting that balance between academics and volume is needed.
摘要：
背景：我们试图探索需要心脏手术的患者中各种外科医生相关和医院级别的特征与临床结果之间的关系。
方法：我们在纽约州心脏数据报告系统中搜索了2015年至2017年之间的所有冠状动脉旁路移植术（CABG）和瓣膜病例。对数据进行无二分法分析。
结果：在CABG/瓣膜外科医生中，病例量与实践年限呈正相关(P=0.002),与风险校正死亡率呈负相关(P=0.014).对于CABG和CABG/瓣膜外科医师，我们的结果显示教学状况与病例数量呈负相关(P=0.002,P=0.018).在CABG外科医生中，医院教学状况和心胸外科住院医师的存在与风险校正后的死亡率呈负相关(P=0.006,P=0.029).
结论：病例体积之间存在复杂的关系，教学现状,和手术结果表明，学术和数量之间的平衡是必要的。
方法：我们在纽约州心脏数据报告系统中搜索了2015年至2017年之间的所有冠状动脉旁路移植术（CABG）和瓣膜病例。对数据进行无二分法分析。
结果：在CABG/瓣膜外科医生中，病例量与实践年限呈正相关(P=0.002),与风险校正死亡率呈负相关(P=0.014).对于CABG和CABG/瓣膜外科医师，我们的结果显示教学状况与病例数量呈负相关(P=0.002,P=0.018).在CABG外科医生中，医院教学状况和心胸外科住院医师的存在与风险校正后的死亡率呈负相关(P=0.006,P=0.029).
结论：病例体积之间存在复杂的关系，教学现状,和手术结果表明，学术和数量之间的平衡是必要的。
