scholarly journals Prediction of Length of Stay Following Elective Percutaneous Coronary Intervention

ISRN Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Abdissa Negassa ◽  
E. Scott Monrad
Keyword(s):  
New York ◽  
Length Of Stay ◽  
New York State ◽  
Risk Groups ◽  
Coronary Intervention ◽  
Classification Model ◽  
Risk Scores ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary ◽  
Using Data

There have been published risk stratification approaches to predict complications following percutaneous coronary interventions (PCI). However, a formal assessment of such approaches with respect to predicting length of stay (LOS) is lacking. Therefore, we sought to assess the performance of, an easy-to-use, tree-structured prognostic classification model in predicting LOS among patients with elective PCI. The study is based on the New York State PCI database. The model was developed on data for 1999-2000, consisting of 67,766 procedures. Validation was carried out, with respect to LOS, using data for 2001-2002, consisting of 79,545 procedures. The risk groups identified by the model exhibited a strong progressively increasing relative risk pattern of longer LOS. The predicted average LOS ranged from 3 to 9 days. The performance of this model was comparable to other published risk scores. In conclusion, the tree-structured prognostic classification is a model which can be easily applied to aid practitioners early on in their decision process regarding the need for extra resources required for the management of more complicated patients following PCI, or to justify to payors the extra costs required for the management of patients who have required extended observation and care after PCI.

Abstract 13567: Variability in Reported Post-percutaneous Coronary Intervention Mortality Among Physicians Practicing at Multiple Sites in New York State

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Nancy Yang ◽  
Peter W Groeneveld ◽  
Sameed Ahmed M Khatana ◽  
Jay S Giri ◽  
Alexander C Fanaroff ◽  
...  
Keyword(s):  
New York ◽  
Percutaneous Coronary Intervention ◽  
New York State ◽  
Rare Event ◽  
Coronary Intervention ◽  
Site Specific ◽  
York State ◽  
Individual Site ◽  
Percutaneous Coronary ◽  
Reported Data

Introduction: New York State (NYS) publicly reports physician-level post-percutaneous coronary intervention (PCI) mortality at each individual site they practice, to empower patients to make informed decisions. Given that mortality is a rare event and some sites have low case volumes, we hypothesized that the reported data at each site for physicians practicing at multiple sites is highly unstable and thus misleading for patients. In this study, we examined variation in site-specific risk-adjusted mortality rates (RAMR) for physicians practicing at multiple sites in NYS. Methods: This study uses publicly reported 30-day physician-level RAMR for all PCI performed in NYS between 2014 and 2016. We obtained the site-specific RAMR (ssRAMR) at each hospital where the physician performed PCI, and overall mean RAMR (mRAMR) for the physician. We excluded physicians who performed PCI at only one hospital. We identified outliers for mRAMR and maximum ssRAMR if values were greater than the 95 th percentile for each measure and plotted the outliers. Results: Between 2014 and 2016, 142,853 PCI procedures were performed by 373 physicians at 61 hospitals. Among 207 (55.5%) physicians practicing at multiple sites who performed 82,075 PCI (57.5%), the median mRAMR was 1.11% (IQR 0.66-1.60%, range 0-5.33%) and the median ssRAMR was 0.52% (IQR 0-1.53%, range 0-47.69%). Among the 11 physicians classified as ssRAMR outliers, only 3 (27.2%) physicians were also classified as an mRAMR outlier. Conclusion: We found that the individual ssRAMRs reported for a physician practicing at multiple hospitals is highly variable, and that mRAMR and ssRAMR outlier status are not consistent with each other. Thus, we believe public reporting of ssRAMR in NYS does not adequately reflect the quality of care delivered by physicians performing PCI. Figure: mRAMR and ssRAMR among maximum ssRAMR outliers. Each letter (A-K) represents a separate outlier physician.

scholarly journals Variability in Reported Percutaneous Coronary Intervention Mortality Among Physicians Practicing at Multiple Sites in New York State

2020 ◽  
Author(s):  
Nancy Yang ◽  
Peter W. Groeneveld ◽  
Sameed Ahmed Mustafa Khatana ◽  
Jay Giri ◽  
Alexander C. Fanaroff ◽  
...  
Keyword(s):  
New York ◽  
Percutaneous Coronary Intervention ◽  
New York State ◽  
Coronary Intervention ◽  
York State ◽  
Percutaneous Coronary

Abstract 16732: Medical Malpractice Claims and Percutaneous Coronary Intervention Mortality Among Interventional Cardiologists - Evidence From New York

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Vishal S Arora ◽  
Robert W Yeh ◽  
Changyu Shen ◽  
Rishi Wadhera
Keyword(s):  
New York ◽  
Percutaneous Coronary Intervention ◽  
Medical Malpractice ◽  
New York State ◽  
Coronary Intervention ◽  
Mortality Rates ◽  
York State ◽  
Malpractice Lawsuit ◽  
Percutaneous Coronary ◽  
Malpractice Claims

Introduction: The medical malpractice liability system aims to identify poorly performing providers and improve the quality and safety of health care by deterring negligence, but there is concern that the current system may not accomplish these objectives. We evaluated whether interventional cardiologists who previously lost or settled a malpractice lawsuit had higher risk-adjusted mortality rates (RAMR) for percutaneous coronary intervention (PCI) in New York State. Methods: We used the Physician Profile website to identify information on demographics as well as lost or settled malpractice lawsuits for interventional cardiologists in New York State between 2010 and 2016. Publicly reported data from the New York State Department of Health was used to determine RAMR for interventional cardiologists who performed PCIs between 2014 and 2016. We then fit a multivariable linear regression model to examine the association between a prior lost or settled malpractice lawsuit and RAMR among interventional cardiologists, adjusted for years in practice, domestic vs. foreign medical graduate, and case volume. Results: We identified 201 interventional cardiologists in New York State between 2014-2016, of whom 16 (8.0%) had lost or settled a malpractice lawsuit. Those with these prior malpractice lawsuits were more likely to be male (100%), domestic graduates (62.5%), spent more years on average [Standard Deviation] in clinical practice (28.8 [9.3] vs. 20.9 [11.2]), and had higher average case volumes (557.0 [290.1] vs. 386.0 [302.1]). After multivariable adjustment, interventional cardiologists with a prior lost or settled malpractice lawsuit had similar RAMRs than those without such a lawsuit (difference: -0.02%, 95% confidence interval -0.47% to +0.42%). Conclusions: We found no relationship between having lost or settled a prior malpractice lawsuit and PCI mortality rates among interventional cardiologists in New York State. These findings raise the possibility that prior malpractice claims do not reliably identify poor-performing providers.

scholarly journals The New York State Risk Score for Predicting In-Hospital/30-Day Mortality Following Percutaneous Coronary Intervention

2013 ◽  
Vol 6 (6) ◽  
pp. 614-622 ◽  
Author(s):  
Edward L. Hannan ◽  
Louise Szypulski Farrell ◽  
Gary Walford ◽  
Alice K. Jacobs ◽  
Peter B. Berger ◽  
...  
Keyword(s):  
New York ◽  
Percutaneous Coronary Intervention ◽  
Risk Score ◽  
New York State ◽  
Coronary Intervention ◽  
York State ◽  
Percutaneous Coronary
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