Variation in outcomes after percutaneous coronary intervention in the united states and predictors of periprocedural mortality
Variation in outcomes after percutaneous coronary intervention in the united states and predictors of periprocedural mortality
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DOI：
10.1159/000084029
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发表时间：
2005-01-01
期刊：
影响因子：
1.9
通讯作者：
Upchurch, GR
中科院分区：
文献类型：
--
作者：
Mukherjee, D;Wainess, RM;Upchurch, GR
这项研究的目的是描述美国不同医院接受经皮冠状动脉介入治疗(PCI)的死亡率的差异。为此，分析了1996年至2001年全国住院患者样本的数据(n=735,022)。分析的主要结果是术后住院死亡率。死亡率按种族、性别、地理区域、并存状态和医院容量计算。死亡率在不同性别组、共病状态、地区和医院容量状况之间存在显著差异。在这个庞大的队列中，死亡率的独立预测因素是年龄较大、女性、收入较低和医院容量较少。这些数据为接受经皮冠状动脉介入治疗的患者提出了质量改进计划的目标，特别是在老年人、女性、低收入患者和低流量医院。即使在当代辅助药物治疗和普遍使用支架的时代，医院容量仍然是住院死亡率的一个重要的独立预测因素。
The objective of this study was to characterize variation in mortality rates across hospitals performing percutaneous coronary intervention (PCI) in the United States. For this purpose, data (n = 735,022) from the Nationwide Inpatient Sample from 1996 to 2001 were analyzed. The primary outcome for the analysis was postprocedural in-hospital mortality. Mortality rates were calculated by race, gender, geographic region, comorbid status and hospital volume. There were significant variations in mortality across gender groups, comorbid status, regions and by hospital volume status. Independent predictors of mortality in this large cohort were older age, female gender, lower income and lower hospital volume. The data suggests targets for quality improvement initiatives for patients undergoing PCI particularly in the elderly, females, lower income patients and low volume hospitals. Even in the contemporary era of adjunctive pharmacological therapies and ubiquitous use of stents, hospital volume remains a significant independent predictor of in-hospital mortality.