{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T22:51:47Z","timestamp":1785451907855,"version":"3.56.0"},"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012553","name":"Chang Gung Memorial Hospital","doi-asserted-by":"publisher","award":["CMRPG3P0801, CORPG3P0511, CORPG3P0541, CORPG3N0281, CORPG3N0282, CORPG3M0371, CORPG3M0372, CORPG3M0373, BMRPD95"],"award-info":[{"award-number":["CMRPG3P0801, CORPG3P0511, CORPG3P0541, CORPG3N0281, CORPG3N0282, CORPG3M0371, CORPG3M0372, CORPG3M0373, BMRPD95"]}],"id":[{"id":"10.13039\/100012553","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC-112-2314-B-182A-107, NSTC-113-2314-B-182A-087"],"award-info":[{"award-number":["NSTC-112-2314-B-182A-107, NSTC-113-2314-B-182A-087"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017667","name":"Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital","doi-asserted-by":"publisher","award":["CLRPG3N0011"],"award-info":[{"award-number":["CLRPG3N0011"]}],"id":[{"id":"10.13039\/100017667","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Over the last decade, the number of patients treated with open repair for TAAAD in Taiwan has dramatically increased. This study aims to assess the hospital-volume relationship with surgical outcomes of type A acute aortic dissection (TAAAD) across hospitals in Taiwan.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Using the Taiwan National Health Insurance (NHI) Research Database (NHIRD), we include only the patients who underwent first open repair for TAAAD from 01\/01\/2005, to 31\/12\/2020, in Taiwan. A total of 8,059 patients in 77 hospitals were eligible for the analysis.<\/jats:p>\n<jats:p>Hospitals were categorized based on their 16-year cumulative volume of TAAAD open repair surgeries, and patients were grouped into quartiles accordingly.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Ascending aortic replacement (55.7%) and partial\/total arch replacement (38.8%) were the most common methods of open aortic repair. In-hospital mortality was 22% and decreased from 28% in 2005 to 20% in 2020. Greater volume (per 5 annual surgeries) was associated with lower risks of in-hospital mortality (odd ratio 0.90, 95% confidence interval [CI] 0.87\u20130.92) and mortality after discharge (hazard ratio 0.97, 95% CI 0.95\u20130.99).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Operative volume inversely correlates to in-hospital mortality and postoperative complications. The volume-outcome effect extends after discharge and reflects better long-term survival. Hospital referral to high-volume centers should be considered in patients needing complex open repair for TAAAD.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0325689","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T17:44:45Z","timestamp":1749577485000},"page":"e0325689","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Hospital volume and outcomes of surgical repair in type A acute aortic dissection: A nationwide cohort study"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6225-146X","authenticated-orcid":true,"given":"Iv\u00e1n Alejandro","family":"De Le\u00f3n 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