Variation in utilization of multivessel percutaneous coronary intervention: influence of hospital volume

Coronary Artery Disease
Nilay PatelCindy L Grines

Abstract

The purpose of this study was to investigate the contemporary trends in the utilization of multivessel percutaneous coronary interventions (MVPCIs) in the USA. We queried the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample between 2006 and 2011 using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure codes 00.40 (single stent), 00.46, 00.47, and 00.48 (single vessel and multiple stents) and 00.41, 00.42 and 00.43 (MVPCI). We built a hierarchical three-level model adjusted for multiple confounding factors. A total of 543 434 (weighted: 2 683 206) procedures were identified. Independent predictors of increased MVPCI utilization (odds ratio, 95% confidence interval, P-value) were found to be age (1.05, 1.04-1.07, P<0.001) and comorbid conditions on using Deyo's modification of Charlson's comorbidity index of at least 2 (1.13, 1.09-1.16, P<0.001). Female sex (0.88, 0.87-0.90, P<0.001), myocardial infarction (0.86, 0.83-0.89, P<0.001), weekend admissions (0.94, 0.91-0.96, P<0.001), and urgent admissions (0.88, 0.83-0.93, P<0.001) predicted decreased utilization. Highest quartile of hospital (1.34, 1.16-1.54, P<0.001) predicted higher utilization. Between-hos...Continue Reading

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Citations

Apr 23, 2016·The American Journal of Cardiology·Vikas SinghAbhijit Ghatak
Jan 9, 2017·The American Journal of Medicine·Vikas SinghJeffrey J Goldberger

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Methods Mentioned

BETA
coronary artery bypass

Software Mentioned

SAS
Stata IC

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