Journal article
Comparison of In-Hospital Mortality, Length of Stay, Postprocedural Complications, and Cost of Single-Vessel Versus Multivessel Percutaneous Coronary Intervention in Hemodynamically Stable Patients With ST-Segment Elevation Myocardial Infarction (from Nationwide Inpatient Sample [2006 to 2012])
The American journal of cardiology, Vol.118(7), pp.950-958
10/01/2016
DOI: 10.1016/j.amjcard.2016.06.057
PMID: 27522303
Abstract
The primary objective of our study was to evaluate the in-hospital outcomes in terms of mortality, procedural complications, hospitalization costs, and length of stay (LOS) after multivessel percutaneous coronary intervention (MVPCI) in hemodynamically stable patients with ST-segment elevation myocardial infarction (STEMI). The study cohort was derived from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database, years 2006 to 2012. Percutaneous coronary interventions (PCI) performed during STEMI were identified using appropriate International Classification of Diseases, Ninth Revision, diagnostic and procedural codes. Patients in cardiogenic shock were excluded. Hierarchical mixed-effects logistic regression models were used for categorical dependent variables such as in-hospital mortality and composite of in-hospital mortality and complications, and hierarchical mixed-effects linear regression models were used for continuous dependent variables such as cost of hospitalization and LOS. We identified 106,317 (weighted n = 525,161) single-vessel PCI and 15,282 (weighted n = 74,543) MVPCIs. MVPCI (odds ratio, 95% confidence interval [CI], p value) was not associated with significant increase in in-hospital mortality (0.99, 0.85 to 1.15, 0.863) but predicted a higher composite end point of in-hospital mortality and postprocedural complications (1.09, 1.02 to 1.17, 0.013) compared to single-vessel PCI. MVPCI was also predictive of longer LOS (LOS +0.19 days, 95% CI +0.14 to +0.23 days, p <0.001) and higher hospitalization costs (cost +$4,445, 95% CI +$4,128 to +$4,762, p <0.001). MVPCI performed during STEMI in hemodynamically stable patients is associated with no increase in in-hospital mortality but a higher rate of postprocedural complications and longer LOS and greater hospitalization costs compared to single-vessel PCI.
Details
- Title: Subtitle
- Comparison of In-Hospital Mortality, Length of Stay, Postprocedural Complications, and Cost of Single-Vessel Versus Multivessel Percutaneous Coronary Intervention in Hemodynamically Stable Patients With ST-Segment Elevation Myocardial Infarction (from Nationwide Inpatient Sample [2006 to 2012])
- Creators
- Sidakpal S Panaich - Cardiology Department, Borgess Medical Center, Kalamazoo, MichiganShilpkumar Arora - Cardiology Department, Mount Sinai St Luke's-Roosevelt Hospital, New York, New YorkNilay Patel - Cardiology Department, Saint Peter's University Hospital, New Brunswick, New JerseyTheodore Schreiber - Cardiology Department, Detroit Medical Center, Detroit, MichiganNileshkumar J Patel - Cardiology Department, University of Miami Miller School of Medicine, Miami, FloridaBhavi Pandya - Cardiology Department, Staten Island University Hospital, Staten Island, New YorkVishal Gupta - Cardiology Department, Borgess Medical Center, Kalamazoo, MichiganCindy L Grines - Cardiology Department, Detroit Medical Center, Detroit, MichiganAbhishek Deshmukh - Cardiology Department, Mayo Clinic, Rochester, MinnesotaApurva O Badheka - Cardiology Department, The Everett Clinic, Everett, Washington. Electronic address: abadheka@everettclinic.com
- Resource Type
- Journal article
- Publication Details
- The American journal of cardiology, Vol.118(7), pp.950-958
- DOI
- 10.1016/j.amjcard.2016.06.057
- PMID
- 27522303
- ISSN
- 0002-9149
- eISSN
- 1879-1913
- Language
- English
- Date published
- 10/01/2016
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984094311402771
Metrics
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