Journal article
In-Hospital Outcomes of Atherectomy During Endovascular Lower Extremity Revascularization
The American journal of cardiology, Vol.117(4), pp.676-684
02/15/2016
DOI: 10.1016/j.amjcard.2015.11.025
PMID: 26732418
Abstract
Contemporary data on clinical outcomes after utilization of atherectomy in lower extremity endovascular revascularization are sparse. The study cohort was derived from Healthcare Cost and Utilization Project nationwide inpatient sample database from the year 2012. Peripheral endovascular interventions including atherectomy were identified using appropriate International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic and procedural codes. The subjects were divided and compared in 2 groups: atherectomy versus no atherectomy. Two-level hierarchical multivariate mixed models were created. The coprimary outcomes were in-hospital mortality and amputation; secondary outcome was a composite of in-hospital mortality and periprocedural complications. Hospitalization costs were also assessed. Atherectomy utilization (odds ratio, 95% CI, p value) was independently predictive of lower in-hospital mortality (0.46, 0.28 to 0.75, 0.002) and lower amputation rates (0.83, 0.71 to 0.97, 0.020). Atherectomy use was also predictive of significantly lower secondary composite outcome of in-hospital mortality and complications (0.79, 0.69 to 0.90, 0.001). In the propensity-matched cohort, atherectomy utilization was again associated with a lower rate of amputation (11.18% vs 12.92%, p = 0.029), in-hospital mortality (0.71% vs 1.53%, p 0.001), and any complication (13.24% vs 16.09%, p 0.001). However, atherectomy use was also associated with higher costs ($24,790 ± 397 vs $22635 ± 251, p <0.001). Atherectomy use in conjunction with angioplasty (with or without stenting) was associated with improved in-hospital outcomes in terms of lower amputation rates, mortality, and postprocedural complications.
Details
- Title: Subtitle
- In-Hospital Outcomes of Atherectomy During Endovascular Lower Extremity Revascularization
- Creators
- Sidakpal S Panaich - Cardiology Department, Borgess Medical Center, Kalamazoo, MichiganShilpkumar Arora - Internal Medicine Department, Mount Sinai St. Luke's Roosevelt Hospital, New York, New YorkNilay Patel - Internal Medicine Department, Saint Peter's University Hospital, New Brunswick, New JerseyNileshkumar J Patel - Cardiology Department, University of Miami Miller School of Medicine, Miami, FloridaSamir V Patel - Internal Medicine Department, Western Reserve Health System, Youngstown, OhioChirag Savani - Epidemiology Department, New York Medical College, New YorkVikas Singh - Cardiology Department, University of Miami Miller School of Medicine, Miami, FloridaSunny Jhamnani - Cardiology Department, Yale School of Medicine, New Haven, ConnecticutRajesh Sonani - Internal Medicine Department, Emory University School of MedicineSopan Lahewala - Internal Medicine Department, Jersey City Medical Center, New Jersey, New JerseyBadal Thakkar - Epidemiology Department, Tulane School of Public Health and Tropical Medicine, New Orleans, LouisianaAchint Patel - Public Health Department, Icahn School of Medicine at Mount Sinai, New York, New YorkAbhishek Dave - Public Health Department, Texas A&M Health Science Center, School of Public Health, College Station, TexasHarshil Shah - Cardiology Department, St. Anthony's Hospital, Oklahoma City, OklahomaParth Bhatt - Epidemiology Department, Tulane School of Public Health and Tropical Medicine, New Orleans, LouisianaRadhika Jaiswal - Cardiology Department, John H. Stroger, Jr. Hospital of Cook County, Chicago, IllinoisAbhijit Ghatak - Cardiology Department, Southwest Heart, Las Cruces, New MexicoVishal Gupta - Cardiology Department, Borgess Medical Center, Kalamazoo, MichiganAbhishek Deshmukh - Cardiology Department, Mayo Clinic, Rochester, MinnesotaAshok Kondur - Cardiology Department, Detroit Medical Center, Detroit, MichiganTheodore Schreiber - Cardiology Department, Detroit Medical Center, Detroit, MichiganCindy Grines - Cardiology Department, Detroit Medical Center, Detroit, MichiganApurva 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.117(4), pp.676-684
- DOI
- 10.1016/j.amjcard.2015.11.025
- PMID
- 26732418
- ISSN
- 0002-9149
- eISSN
- 1879-1913
- Language
- English
- Date published
- 02/15/2016
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984094395502771
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