Multivessel Percutaneous Coronary Interventions in the United States: Insights From the Nationwide Inpatient Sample

作者：Arora Shilpkumar; Panaich Sidakpal S; Patel Nileshkumar J; Patel Nilay; Solanki Shantanu; Deshmukh Abhishek; Singh Vikas; Lahewala Sopan; Savani Chirag; Thakkar Badal; Dave Abhishek; Patel Achint; Bhatt Parth; Sonani Rajesh; Patel Aashay; Cleman Michael; Forrest John K; Schreiber Theodore; Badheka Apurva O^*; Grines Cindy

来源：Angiology, 2016, 67(4): 326-335.

DOI：10.1177/0003319715593853

• multivessel percutaneous coronary interventions
• mortality
• hospital volume

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.

• 出版日期2016-4
• 单位河北医科大学