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Surgical treatment of intact thoracoabdominal aortic aneurysm (TAAA) is crucial to prevent rupture but is associated with high perioperative mortality. We tested the hypothesis that provider volume of surgical treatment of TAAA is an important determinant of operative outcome.

Clinical information regarding repair of intact TAAA in 1542 patients from 1988 to 1998 was obtained from the Nationwide Inpatient Sample (NIS), a stratified discharge database of a representative 20% of US hospitals. Demographic data included age, sex, race, nature of admission, and comorbid conditions. Annual hospital volume of TAAA treated was grouped into terciles and defined as low (LVH; 1-3 cases [median, 1]), medium (MVH; 2-9 cases [median, 4]), or high (HVH; 5-31 cases [median, 12]). Annual surgeon volume was defined as low (LVS; 1-2 cases [median, 1]) or high (HVS; 3-18 cases …