Author + information
- William J. Bommer,
- Beate Danielsen,
- Joseph Carey,
- Suresh Ram and
- Jason Rogers
Background: Although statewide and individual hospital PCI outcome variation is known in the 3 PCI Public Reporting States, this complete information is not available in Non-Reporting states.
Methods: To evaluate statewide and individual PCI outcomes in the largest Non-Reporting state, we obtained initial mortality (M), major adverse cardiovascular events (MACE) (mortality, myocardial infarction, stroke, re-intervention), and 90-day outcomes (MACE90) data from 95,598 PCIs (42,087 without acute coronary syndrome (ACS)) performed from 2013–14 in all 168 California non-federal PCI hospitals from the patient discharge, emergency and ambulatory databases of the Office of Statewide Health Planning and Development to create a risk-adjusted model for outcomes.
Results: Significant Model risk factors included cardiogenic shock, heart failure, diabetes, dialysis, renal failure, urgent status, cardiac arrest, chronic lung, cerebrovascular, and peripheral vascular diseases. Statewide outcomes for M, MACE, and MACE90 for PCI patients With and Without ACS and the number of risk-adjusted hospital outliers are shown in table 1. Individual risk-adjusted hospital outcomes revealed PCI volumes of 47–2756, and significantly worse outcomes (outliers) for M (9 hospitals), MACE (17 hospitals), and MACE90 (15–20 hospitals).
Conclusions: Unreported PCI outcomes show a wide variation in hospital outcomes with a significant number of worse outliers. Further notification and quality improvement measures are warranted for these PCI outlier hospitals.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: PCI for NSTEMI and Complex Patients With Multiple Co-Morbidities
Abstract Category: 19. Interventional Cardiology: Complex Patients/Comorbidities
Presentation Number: 1154-133
- 2017 American College of Cardiology Foundation