Outcomes and Temporal Trends of Inpatient Percutaneous Coronary Intervention at Centers With and Without On-site Cardiac Surgery in the United States
Key result
Inpatient PCI at centers without on-site cardiac surgery had similar adjusted in-hospital mortality compared to centers with on-site surgery (OR 1.01; 95% CI 0.98-1.03; P=0.62).
Why the study?
Does inpatient PCI at centers without on-site cardiac surgery increase in-hospital mortality compared to centers with on-site cardiac surgery in patients undergoing inpatient PCI?
Population
6,912,232 patients who underwent inpatient percutaneous coronary intervention in the United States from…
Comparison
Inpatient percutaneous coronary intervention at… vs Inpatient percutaneous coronary intervention at…
Design
Cohort
Follow-up
in-hospital
Authors
Discussion
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Member takes
Implication
Similar adjusted mortality supports PCI without on-site surgery in unselected inpatients; leaves open need for prospective volume-outcome confirmation.
Study Design
Type
Cohort (n=6,912,232)
Multicenter
Yes
Structured PICO
Does inpatient PCI at centers without on-site cardiac surgery increase in-hospital mortality compared to centers with on-site cardiac surgery in patients undergoing inpatient PCI?
P
Population
6,912,232 patients (mean age 64.5 years, 33.8% female) who underwent inpatient PCI in the United States from 2003 to 2012.
E
Exposure
Inpatient percutaneous coronary intervention (PCI) at centers without on-site cardiac surgery
C
Comparator
Inpatient percutaneous coronary intervention (PCI) at centers with on-site cardiac surgery
O
Outcome
In-hospital mortalityhard clinical
Main Result
Odds Ratio: 1.01 (95% CI 0.98–1.03)
Absolute Event Rate: 1.9% vs 1.4%
p-value: p=.62
Inpatient PCI at centers without on-site cardiac surgery is associated with similar adjusted in-hospital mortality compared to centers with on-site cardiac surgery, supporting its safety in the modern era.
Cite This Study
Goel et al. (2016) conducted a cohort in Inpatient percutaneous coronary intervention (PCI) (n=6,912,232). Inpatient PCI at centers without on-site cardiac surgery vs. Inpatient PCI at centers with on-site cardiac surgery was evaluated on In-hospital mortality (OR 1.01, 95% CI 0.98-1.03, p=.62). Inpatient PCI at centers without on-site cardiac surgery had similar adjusted in-hospital mortality compared to centers with on-site surgery (OR 1.01; 95% CI 0.98-1.03; P=0.62).