Coronary revascularization trends in the United States, 2001-2008.

Coronary revascularization trends in the United States, 2001-2008.
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DOI:
10.1001/jama.2011.551
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发表时间:
2011-05-04
影响因子:
120.7
通讯作者:
Groeneveld, Peter W.
Groeneveld, Peter W.
中科院分区:
医学1区
文献类型:
--
作者:
Epstein, Andrew J.;Polsky, Daniel;Yang, Feifei;Yang, Lin;Groeneveld, Peter W.

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Coronary revascularization is among the most common hospital-based major interventional procedures performed in the United States. It is uncertain how new revascularization technologies, new clinical evidence from trials, and updated clinical guidelines have influenced the volume and distribution of coronary revascularizations over the past decade. To examine national time trends in the rates and types of coronary revascularizations during 2001–2008. Serial cross-sectional study with time trends. U.S. hospitals in the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample providing coronary revascularization, supplemented by Medicare hospital claims. Patients undergoing coronary artery bypass grafting (CABG) or percutaneous coronary interventions (PCI) from 2001–2008. Annual procedure rates. There was a 14% decrease (p<0.001) in the annual rate of coronary revascularizations between 2001 and 2008. The annual CABG rate decreased steadily from 1,742 CABGs per million adults per year in 2001–02 to 1,081 CABGs per million adults per year in 2007–08 (p<0.001), but PCI rates did not significantly change, from 3,827 PCI per million adults per year in 2001–02 to 3,667 PCI per million adults per year in 2007–08 (p=0.74). Between 2001 and 2008 the number of hospitals in the Nationwide Inpatient Sample providing CABG increased by 14% (p=0.03), while the number of PCI hospitals increased by 35% (p<0.001). The median CABG caseload per hospital declined by 28% (p<0.001), and the percentage of CABG hospitals providing fewer than 100 CABGs per year increased from 11% to 26% (p<0.001). In U.S. hospitals from 2001–2008, there was a substantial decrease in CABG utilization rates, but PCI utilization rates remained unchanged.
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DOI: 10.1001/jama.297.2.joc60179
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