Journal article
Impact of symptoms, gender, co-morbidities, and operator volume on outcome of carotid artery stenting (from the Nationwide Inpatient Sample [2006 to 2010])
The American journal of cardiology, Vol.114(6), pp.933-941
09/15/2014
DOI: 10.1016/j.amjcard.2014.06.030
PMID: 25208563
Abstract
The increase in the number of carotid artery stenting (CAS) procedures over the last decade has necessitated critical appraisal of procedural outcomes and patterns of utilization including cost analysis. The main objectives of our study were to evaluate the postprocedural mortality and complications after CAS and the patterns of resource utilization in terms of length of stay (LOS) and cost of hospitalization. We queried the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample from 2006 to 2010 using the International Classification of Diseases, Ninth Revision, procedure code of 00.63 for CAS. Hierarchical mixed-effects models were generated to identify the independent multivariate predictors of in-hospital mortality, procedural complications, LOS, and cost of hospitalization. A total of 13,564 CAS procedures (weighted n = 67,344) were analyzed. The overall postprocedural mortality was low at 0.5%, whereas the complication rate was 8%, both of which remained relatively steady over the time frame of the study. Greater postoperative mortality and complications were noted in symptomatic patients, women, and those with greater burden of baseline co-morbidities. A greater operator volume was associated with a lower rate of postoperative mortality and complications, as well as shorter LOS and lesser hospitalization costs. In conclusion, the postprocedural mortality after CAS has remained low over the recent years. Operator volume is an important predictor of postprocedural outcomes and resource utilization.
Details
- Title: Subtitle
- Impact of symptoms, gender, co-morbidities, and operator volume on outcome of carotid artery stenting (from the Nationwide Inpatient Sample [2006 to 2010])
- Creators
- Apurva O Badheka - Cardiovascular Institute, Detroit Medical Center, Detroit, Michigan. Electronic address: apurva.badheka@yale.eduAnkit Chothani - MedStar Washington Hospital Center, Washington, DCSidakpal S Panaich - Cardiovascular Institute, Detroit Medical Center, Detroit, MichiganKathan Mehta - University of Pittsburgh Medical Center, Shadyside Hospital, Pittsburgh, PennsylvaniaNileshkumar J Patel - Staten Island University Hospital, Staten Island, New YorkAbhishek Deshmukh - University of Arkansas, Little Rock, ArkansasVikas Singh - University of Miami Miller School of Medicine, Miami, FloridaShilpkumar Arora - Cardiovascular Institute, Detroit Medical Center, Detroit, MichiganNilay Patel - Cardiovascular Institute, Detroit Medical Center, Detroit, MichiganPeeyush Grover - University of Miami Miller School of Medicine, Miami, FloridaNeeraj Shah - Staten Island University Hospital, Staten Island, New YorkChirag N Savani - Cardiovascular Institute, Detroit Medical Center, Detroit, MichiganAchint Patel - Cardiovascular Institute, Detroit Medical Center, Detroit, MichiganVinaykumar Panchal - Cardiovascular Institute, Detroit Medical Center, Detroit, MichiganMichael Brown - Cardiovascular Institute, Detroit Medical Center, Detroit, MichiganAmir Kaki - Cardiovascular Institute, Detroit Medical Center, Detroit, MichiganAshok Kondur - Cardiovascular Institute, Detroit Medical Center, Detroit, MichiganTamam Mohamad - Cardiovascular Institute, Detroit Medical Center, Detroit, MichiganMahir Elder - Cardiovascular Institute, Detroit Medical Center, Detroit, MichiganCindy Grines - Cardiovascular Institute, Detroit Medical Center, Detroit, MichiganTheodore Schreiber - Cardiovascular Institute, Detroit Medical Center, Detroit, Michigan
- Resource Type
- Journal article
- Publication Details
- The American journal of cardiology, Vol.114(6), pp.933-941
- DOI
- 10.1016/j.amjcard.2014.06.030
- PMID
- 25208563
- ISSN
- 0002-9149
- eISSN
- 1879-1913
- Language
- English
- Date published
- 09/15/2014
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984094372002771
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