Hospital mortality for Norwood and arterial switch operations as a function of institutional volume.

Regionalization of complex surgical procedures to high-volume centers is a model for improving hospital survival. We analyzed the effect of institutional volume on hospital mortality for the Norwood and arterial switch operations (ASO) as representative high-complexity neonatal cardiac procedures. Analysis of discharge data from the 2003 Kids' Inpatient Database (KID) was conducted. Association between institutional volume and in-hospital mortality was examined for the ASO or Norwood procedure. Logistic regression analysis was performed to calculate the probability of hospital mortality for both procedures.Significant inverse associations between institutional volume and in-hospital mortality for the Norwood procedure (p