Author + information
- Gaurav Patel,
- Anvit Rai,
- Maitri Pancholy,
- Sukrut Nanavaty,
- Mark Sandhaus,
- Aman Patel,
- Tejas Patel,
- Hemant Tiwari,
- John Coppola,
- Tak Kwan and
- Samir Pancholy
Background: Non-procedural predictors of complications of elective PCI are poorly defined.
Methods: Using the Nationwide Inpatient Sample (NIS) data from 1998-2013, we identified patients 18 years of age and older who were electively admitted for PCI. Post-PCI complications were defined as the occurrence of any of the following: acute cerebrovascular accident (ACVA), acute kidney injury (AKI), vascular complications, iatrogenic cardiac complications, cardiogenic shock, cardiac arrest or in-hospital mortality. Post-PCI same-day discharges were identified. Binary logistic regression was used to identify the independent predictors of post-PCI complications. Using regression coefficients from the multi-variate model, we developed a risk model to predict post-PCI complications in 80% of the sample, which was then validated in the remaining 20%.
Results: We identified 372,885 patients who were electively admitted for PCI as the primary procedure. 18,456 patients (4.94%) developed post-PCI complications. 42 patients (0.2%) were discharged on the same day following PCI. Multiple independent predictors of post-PCI complications were identified [(O.R., 95% CI, p-value), age (1.011, 1.009-1.012, 0.0005), female gender (1.484, 1.439-1.530, 0.0005), acute myocardial infarction (4.321, 4.122-4.530, 0.0005), hypertension (1.257, 1.172-1.347, 0.0005), congestive heart failure (1.186, 1.124-1.251, 0.0005), diabetes with end organ damage (1.332, 1.227-1.445, 0.0005), atrial fibrillation (1.540, 1.461-1.623, 0.0005), chronic kidney disease (1.187, 1.086-1.297, 0.0005) and Charlson comorbidity index (1.159, 1.145-1.173, 0.0005)], although the model poor-fit with suboptimal discriminatory power both in development and validation samples, as evident by the C statistic of 0.617 and 0.612, respectively.
Conclusions: Demographic and other non-procedural patient characteristics lack the ability to adequately predict short-term adverse outcomes in patients electively admitted for PCI and should not be used in the decision-making for same-day discharge following the procedure.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Complexity and Complications
Abstract Category: 26. Interventional Cardiology: Vascular Access and Complications
Presentation Number: 1285-158
- 2017 American College of Cardiology Foundation