Key result
Multivessel PCI is linked to higher mortality, longer stays, and greater costs than single-vessel PCI.
Why the study?
Does multivessel percutaneous coronary intervention affect inhospital mortality, length of stay, and costs compared to single vessel single stent PCI?
Observational
Yes
Does multivessel percutaneous coronary intervention affect inhospital mortality, length of stay, and costs compared to single vessel single stent PCI?
Multivessel PCI is associated with higher inhospital mortality, length of stay, and costs compared to single vessel single stent PCI, though overall mortality remains low.
Multivessel PCI was associated with higher in-hospital mortality, stay, and costs than single-vessel PCI; leaves open selection bias versus causal risk.
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.
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Arora et al. (2015) conducted an observational in Multivessel coronary artery disease. Multivessel percutaneous coronary intervention (MVPCI) vs. Single vessel single stent PCI was evaluated on Inhospital all-cause mortality. Multivessel percutaneous coronary intervention had an overall inhospital mortality of 0.73%, but was associated with higher mortality, length of stay, and costs compared to single vessel PCI.
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