Impact of Percutaneous Coronary Intervention on in Hospital Mortality in Cardiac Arrest – A National Perspective

2016 ◽  
Vol 4 (3) ◽  
Author(s):  
Byomesh Tripathi ◽  
Shilpkumar Arora ◽  
Sidakpal Panaich ◽  
Sopan Lahewala ◽  
Nilay Patel
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cardiac Arrest ◽  
Hospital Mortality ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
National Perspective

scholarly journals Outcomes following primary percutaneous coronary intervention in the setting of cardiac arrest: A registry database study

2014 ◽  
Vol 4 (1) ◽  
pp. 6-15 ◽  
Author(s):  
Vijay Kunadian ◽  
Bilal Bawamia ◽  
Annette Maznyczka ◽  
Azfar Zaman ◽  
Weiliang Qiu
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cardiac Arrest ◽  
Hospital Mortality ◽  
Primary Percutaneous Coronary Intervention ◽  
Multiple Logistic Regression Analysis ◽  
Female Gender ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Cardiac Centre ◽  
St Elevation

Background: The mortality rate among patients undergoing primary percutaneous coronary intervention (PPCI) in the setting of cardiac arrest (CA) and whether the location where the patient sustains CA influences the outcome is not known in the contemporary era. Methods: Prospectively collected data at a tertiary cardiac centre on all patients undergoing PPCI for ST elevation myocardial infarction (STEMI) in the setting of CA was analysed. Results: In total, 484/4118 (11.8%) patients sustained CA during the study period. Of these, 91/484 (18.8%) sustained CA prior to ambulance arrival, the remainder occurred either after ambulance arrival or in hospital. The overall in-hospital mortality was 20.5% in this cohort. Those sustaining CA before ambulance arrival experienced the highest unadjusted mortality compared to those that had CA after ambulance arrival, in hospital and in the catheterisation laboratory (29.7% versus 12.0%, 16.1% and 23.8% respectively, p=0.03). Multiple logistic regression analysis showed that the following parameters are independent predictors of in-hospital mortality: age (odds ratio (OR) for each year increment of age 1.05; 95% confidence interval (CI) 1.02–1.08, p=0.0009); female gender (OR 2.42; 95% CI 1.17–4.99, p=0.0173); previous PCI (OR 7.59; 95% CI 1.72–33.53, p=0.0075); asystole/ electromechanical dissociation (EMD) (OR 13.43; 95% CI 5.34–33.80, p<0.0001); and patient location at arrest (OR 5.77 for before ambulance arrival; 95% CI 2.55–13.07, p<0.0001). Conclusions: In conclusion, in-hospital mortality remains high among patients undergoing PPCI in the context of CA, particularly among those that arrest prior to ambulance arrival.

scholarly journals In-Hospital Mortality in Patients Receiving Percutaneous Coronary Intervention According to Nurse Staffing Level: An Analysis of National Administrative Health Data

2020 ◽  
Vol 17 (11) ◽  
pp. 3799
Author(s):  
Yunmi Kim ◽  
Jiyun Kim
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Nurse Staffing ◽  
Coronary Intervention ◽  
First Grade ◽  
Estimation Model ◽  
Staffing Level ◽  
Percutaneous Coronary ◽  
General Wards

The increasing incidence of ischemic heart disease is concomitantly increasing percutaneous coronary intervention (PCI) treatments. Adequate nurse staffing has enhanced quality of care and this study was conducted to determine the relationship between survival-related PCI treatment and the level of nursing staff who care for patients admitted to receive PCI. National Health Insurance claims data from 2014 to 2015 for 67,927 patients who underwent PCI in 43 tertiary hospitals were analyzed. The relationships of nurse staffing in intensive care units (ICUs) and general wards with survival after PCI were investigated using logistic regression analyses with a generalized estimation model. The in-hospital mortality rate in ICUs was lower in hospitals with first-grade nurse staffing {odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.23–0.48}, second-grade nurse staffing (OR = 0.55, 95% CI = 0.40–0.77), or third-grade nurse staffing (OR = 0.71, 95% CI = 0.53–0.95) than in hospitals with fifth-grade nurse staffing. Nurse staffing in general wards was not related to in-hospital mortality due to PCI treatment. This study found that nurse staffing in PCI patients requiring short-term intensive care significantly affected patient survival. An understanding of the importance of managing the ICU nursing workforce for PCI treatment is required.

scholarly journals TRENDS, PREDICTORS, AND OUTCOMES OF PERCUTANEOUS CORONARY INTERVENTION COMPLICATED BY IN-HOSPITAL CARDIAC ARREST

2021 ◽  
Vol 77 (18) ◽  
pp. 203
Author(s):  
Temidayo Abe ◽  
Titilope Olanipekun ◽  
Valery S. Effoe ◽  
Joseph Igwe ◽  
Obiora Egbuche ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cardiac Arrest ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Hospital Cardiac Arrest

scholarly journals Retrospective cohort analysis of Spanish national trends of coronary artery bypass grafting and percutaneous coronary intervention from 1998 to 2017

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e046141
Author(s):  
Manuel Carnero Alcazar ◽  
Daniel Hernandez-Vaquero ◽  
Hector Cubero-Gallego ◽  
Jose Lopez Menendez ◽  
Miguel Piñon ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Hospital Mortality ◽  
Retrospective Cohort ◽  
Artery Bypass ◽  
National Health System ◽  
Coronary Intervention ◽  
Bypass Grafting ◽  
Percutaneous Coronary

IntroductionSpain is one of the countries with the lowest rates of revascularisation and highest ratio of percutaneous coronary intervention (PCI) to coronary artery bypass grafting (CABG).ObjectivesTo investigate the changes and trends in the two revascularisation procedures between 1998 and 2017 in Spain.DesignRetrospective cohort study. Analysis of in-hospital outcomes.SettingMinimum basic data set from the Spanish National Department of Health: mandatory database collecting information of patients who are attended in the Spanish public National Health System.Participants603 976 patients who underwent isolated CABG or PCI in the Spanish National Health System. The study period was divided in four 5-year intervals. Patients with acute myocardial infarction on admission were excluded.Primary and secondary outcomesWe investigated the volume of procedures nationwide, the changes of the risk profile of patients and in-hospital mortality of both techniques.ResultsWe observed a 2.2-fold increase in the rate of any type of myocardial revascularisation per million inhabitants-year: 357 (1998) to 776 (2017). 93 682 (15.5%) had a coronary surgery. PCI to CABG ratio rose from 2.2 (1998–2002) to 8.1 (2013–2017). Charlson’s index increased by 0.8 for CABG and 1 for PCI. The median annual volume of PCI/hospital augmented from 136 to 232, while the volume of CABG was reduced from 137 to 74. In the two decades, we detected a significant reduction of CABG in-hospital mortality (6.5% vs 2.6%, p<0.001) and a small increase in PCI (1.2% vs 1.5%, p<0.001). Risk adjusted mortality rate was reduced for both CABG (1.51 vs 0.48, p<0.001), and PCI (1.42 vs 1.05, p<0.001).ConclusionWe detected a significant increase in the volume of revascularisations (particularly PCI) in Spain. Risk-adjusted in-hospital mortality was significantly reduced.

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