TY - JOUR
T1 - Multivessel percutaneous coronary interventions in the United States
AU - Arora, Shilpkumar
AU - Panaich, Sidakpal S.
AU - Patel, Nileshkumar J.
AU - Patel, Nilay
AU - Solanki, Shantanu
AU - Deshmukh, Abhishek
AU - Singh, Vikas
AU - Lahewala, Sopan
AU - Savani, Chirag
AU - Thakkar, Badal
AU - Dave, Abhishek
AU - Patel, Achint
AU - Bhatt, Parth
AU - Sonani, Rajesh
AU - Patel, Aashay
AU - Cleman, Michael
AU - Forrest, John K.
AU - Schreiber, Theodore
AU - Badheka, Apurva O.
AU - Grines, Cindy
N1 - Publisher Copyright:
© 2015 SAGE Publications.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Background: Multivessel coronary artery disease carries significant mortality risk. Comprehensive data on inhospital outcomes following multivessel percutaneous coronary intervention (MVPCI) are sparse. Methods: We queried the Healthcare Cost and Utilization Project's nationwide inpatient sample (NIS) between 2006 and 2011 using different International Classification of Diseases, 9th Revision, Clinical Modification procedure codes. The primary outcome was inhospital all-cause mortality, and the secondary outcome was a composite of inhospital mortality and periprocedural complications. Results: The overall mortality was low at 0.73% following MVPCI. Multivariate analysis revealed that (odds ratio, 95% confidence interval, P value) age (1.63, 1.48-1.79; <.001), female sex (1.19, 1.00-1.42; P =.05), acute myocardial infarction (AMI; 2.97, 2.35-3.74; <.001), shock (17.24, 13.61-21.85; <.001), a higher burden of comorbidities (2.09, 1.32-3.29;.002), and emergent/urgent procedure status (1.67, 1.30-2.16; <.001) are important predictors of primary and secondary outcomes. MVPCI was associated with higher mortality, length of stay (LOS), and cost of care as compared to single vessel single stent PCI. Conclusion: MVPCI is associated with higher inhospital mortality, LOS, and hospitalization costs compared to single vessel, single stent PCI. Higher volume hospitals had lower overall postprocedural mortality rate along with shorter LOS and lower hospitalization costs following MVPCI.
AB - Background: Multivessel coronary artery disease carries significant mortality risk. Comprehensive data on inhospital outcomes following multivessel percutaneous coronary intervention (MVPCI) are sparse. Methods: We queried the Healthcare Cost and Utilization Project's nationwide inpatient sample (NIS) between 2006 and 2011 using different International Classification of Diseases, 9th Revision, Clinical Modification procedure codes. The primary outcome was inhospital all-cause mortality, and the secondary outcome was a composite of inhospital mortality and periprocedural complications. Results: The overall mortality was low at 0.73% following MVPCI. Multivariate analysis revealed that (odds ratio, 95% confidence interval, P value) age (1.63, 1.48-1.79; <.001), female sex (1.19, 1.00-1.42; P =.05), acute myocardial infarction (AMI; 2.97, 2.35-3.74; <.001), shock (17.24, 13.61-21.85; <.001), a higher burden of comorbidities (2.09, 1.32-3.29;.002), and emergent/urgent procedure status (1.67, 1.30-2.16; <.001) are important predictors of primary and secondary outcomes. MVPCI was associated with higher mortality, length of stay (LOS), and cost of care as compared to single vessel single stent PCI. Conclusion: MVPCI is associated with higher inhospital mortality, LOS, and hospitalization costs compared to single vessel, single stent PCI. Higher volume hospitals had lower overall postprocedural mortality rate along with shorter LOS and lower hospitalization costs following MVPCI.
KW - hospital volume
KW - mortality
KW - multivessel percutaneous coronary interventions
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U2 - 10.1177/0003319715593853
DO - 10.1177/0003319715593853
M3 - Article
C2 - 26145455
AN - SCOPUS:84959298191
SN - 0003-3197
VL - 67
SP - 326
EP - 335
JO - Angiology
JF - Angiology
IS - 4
ER -