Decline in the nationwide trends in in-hospital mortality of patients undergoing multivessel percutaneous coronary intervention

J Invasive Cardiol. 2009 Aug;21(8):388-90.

Abstract

Background: Advances in the safety of percutaneous coronary interventions have been significant in recent years. The goal of this study was to evaluate any decline in the age-adjusted in-hospital mortality rate in patients undergoing multivessel percutaneous coronary intervention (MVPCI) using a very large database from 1988 to 2004 in the United States.

Method: The Nationwide Inpatient Sample (NIS) database was utilized to calculate the age-adjusted mortality rate for MVPCI from 1988 to 2004 in patients over the age of 40 years retrospectively. Specific ICD-9-CM codes for MVPCI were used for this study. Patient demographic data were also analyzed and adjusted for age from the database.

Results: The mean age was 71.56 +/- 10.59 years (53.55% male). From 1988 the age-adjusted mortality rate was stable until 1999, with a steady decline to the lowest level in 2004. In 1988, the rate was 67.42 (95% CI = 181-316.14), in 1999 51.02 (95% CI = 27-129.32), and in 2004, 40.06 (95% CI 5.6-85.83) per 100,000. Total death also declined from 1.77% to 1.25%. This trend was similar across gender and ethnicities.

Conclusion: The age-adjusted mortality from MVPCI was steady until 1999, but declined to the lowest level in 2004. This trend most likely reflects advancements in the care of patients undergoing high-risk coronary interventions.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary / instrumentation
  • Angioplasty, Balloon, Coronary / methods
  • Angioplasty, Balloon, Coronary / mortality*
  • Coronary Artery Disease / therapy
  • Drug-Eluting Stents
  • Female
  • Hospital Mortality / trends*
  • Humans
  • International Classification of Diseases
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome
  • United States