Table 2. Baseline, Operative, and Mortality Details by Center Volume (Tertiles of Latest 3‐Year Activity) (NACSA Cohort)
Patient FactoraLow‐Volume Center (n=1308)Medium‐Volume Center (n=2159)High‐Volume Center (n=4591)
Demographics
Age at operation, y64 (52, 72)64 (52, 73)64 (51, 73)
BMI, kg/m227.2 (24.4, 30.2)27.0 (24.1, 30.4)26.7 (23.9, 29.9)
Female sex450 (34.4)715 (33.1)1526 (33.2)
Comorbidities
Unstable angina77 (5.9)114 (5.3)181 (3.9)
NYHA ≥III411 (31.4)721 (33.4)1184 (25.8)
MI within 90 days of operation58 (4.4)72 (3.3)138 (3.0)
Previous cardiac surgery150 (11.5)307 (14.2)795 (17.3)
Previous aortic surgery27 (2.1)71 (3.3)237 (5.2)
Diabetes mellitus102 (7.8)175 (8.1)276 (6.0)
Current smoker166 (12.7)236 (12.2)478 (10.4)
Hypertension838 (64.1)1419 (65.7)2779 (60.5)
Creatinine >200 μmol/L39 (3.0)62 (2.9)123 (2.7)
History of renal dysfunction16 (1.2)37 (1.7)81 (1.8)
History of pulmonary disease153 (11.7)267 (12.4)554 (12.1)
History of stroke119 (9.1)192 (8.9)350 (7.6)
Neurological dysfunction55 (4.2)91 (4.2)160 (3.5)
Peripheral vascular disease213 (16.3)452 (20.9)647 (14.1)
Preoperative nonsinus heart rhythm182 (13.9)278 (12.9)478 (10.4)
Triple vessel disease68 (5.2)134 (6.2)169 (3.7)
Left main stem disease30 (2.3)45 (2.1)77 (1.7)
Moderate ejection fraction (30–50%)308 (23.6)419 (19.4)857 (18.7)
Poor ejection fraction (<30%)57 (4.4)92 (4.3)179 (3.9)
PA systolic >60 mm Hg26 (2.0)26 (1.2)42 (0.9)
Preoperative IV nitrates62 (4.7)118 (5.5)231 (5.0)
Preoperative IV inotropes35 (2.7)58 (2.7)133 (2.9)
Preoperative ventilation22 (1.7)42 (2.0)102 (2.2)
Preoperative cardiogenic shock88 (6.7)100 (4.6)154 (3.4)
Nonelective priority497 (38.0)801 (37.1)1643 (35.8)
Urgent priority202 (15.4)396 (18.3)697 (15.2)
Emergency priority267 (20.4)355 (16.4)888 (19.3)
Salvage priority28 (2.1)50 (2.3)58 (1.3)
Dominant pathology
Aneurysm697 (53.3)1248 (57.8)2477 (54.0)
Dissection326 (24.9)481 (22.3)1012 (22.0)
Trauma7 (0.5)7 (0.3)36 (0.8)
“Other”166 (12.7)366 (17.0)702 (15.3)
Data N/A112 (8.6)57 (2.6)364 (7.9)
Aortic segment
Root/ascending aorta1211 (92.6)1798 (83.3)3839 (83.6)
Aortic arch75 (5.7)275 (12.7)412 (9.0)
Descending aorta17 (1.3)58 (2.7)245 (5.3)
Thoracoabdominal aorta5 (0.4)28 (1.3)95 (2.1)
Surgical data
Concomitant valve operation948 (72.5)1339 (62.0)3032 (66.0)
Concomitant CABG operation237 (18.1)399 (18.5)846 (18.4)
Concomitant “other” cardiac operation510 (39.0)728 (33.7)1408 (30.7)
CPB time, min178 (129, 240)152 (114, 208)162 (116, 229)
ACC time, min114 (82, 154)104 (74, 136)105 (75, 143)
Circulatory arrest time, min26 (18, 37)25 (17, 34)27 (18, 39)
Outcome
In‐hospital mortality138 (10.6)206 (9.5)404 (8.8)
  • ACC indicates aortic cross‐clamp; BMI, body mass index; CABG, coronary artery bypass grafting; CPB, cardiopulmonary bypass; IV, intravenous; NACSA, National Adult Cardiac Surgery audit; N/A, not available; NYHA, New York Heart Association; PA, pulmonary artery.

  • a Numerical data are expressed as median and interquartile range (IQR); categorical data as absolute number (percentage).