Relationship between annualized case volume and in-hospital motality in subarachnoid hemorrhage: A systematic review and meta-analysis |
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Authors: | Jian-Yi Huang Hong-Yu Lin Qing-Qing Wei Xing-Hua Pan Ning-Chao Liang Wen Gao Sheng-Liang Shi |
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Institution: | aDepartment of Neurology, People''s Hospital of Chongzuo city, Chongzuo, Guangxi Zhuang Autonomous Region, China;bDepartment of Neurology, People''s Hospital of Liuzhou city, Liuzhou, Guangxi Zhuang Autonomous Region, China;cDepartment of Neurology, Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China. |
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Abstract: | Studies on the relationship between hospital annualized case volume and in-hospital mortality in patients with subarachnoid hemorrhage (SAH) have shown conflicting results. Therefore, we performed a meta-analysis to further examine this relationship.The authors searched the PubMed and Embase databases from inception through July 2020 to identify studies that assessed the relationship between hospital annualized SAH case volume and in-hospital SAH mortality. Studies that reported in-hospital mortality in SAH patients and an adjusted odds ratio (OR) comparing mortality between low-volume and high-volume hospitals or provided core data to calculate an adjusted OR were eligible for inclusion. No language or human subject restrictions were imposed.Five retrospective cohort studies with 46,186 patients were included for analysis. The pooled estimate revealed an inverse relationship between annualized case volume and in-hospital mortality (OR, 0.53; 95% confidence interval, 0.42–0.68, P < .0001). This relationship was consistent in almost all subgroup analyses and was robust in sensitivity analyses.This meta-analysis confirms an inverse relationship between hospital annualized SAH case volume and in-hospital SAH mortality. Higher annualized case volume was associated with lower in-hospital mortality. |
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Keywords: | case volume hospital volume in-hospital motality meta-analysis subarachnoid hemorrhage |
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