Impact of Inpatient Percutaneous Coronary Intervention Volume on 30-Day Readmissions After Acute Myocardial Infarction-Cardiogenic Shock

被引：4

作者：

Bansal, Kannu ^{[1
]}

Gupta, Mohak ^{[2
]}

Garg, Mohil ^{[3
]}

Patel, Neel ^{[4
]}

Truesdell, Alexander G. ^{[5
]}

Basir, Mir Babar ^{[6
]}

Rab, Syed Tanveer ^{[7
]}

Ahmad, Tariq ^{[8
]}

Kapur, Navin K. ^{[9
]}

Desai, Nihar ^{[8
]}

Vallabhajosyula, Saraschandra ^{[10
,11
]}

机构：

[1] St Vincent Hosp, Dept Med, Worcester, MA USA

[2] Cleveland Clin, Dept Med, Cleveland, OH USA

[3] Medstar Washington Hosp Ctr, Dept Med, Washington, DC USA

[4] Landmark Med Ctr, Dept Med, Woonsocket, RI USA

[5] Inova Fairfax Heart & Vasc Inst, Virginia Heart, Dept Med, Sect Cardiovasc Med, Inova Fairfax Med Campus,3300 Gallows Rd, Falls Church, VA 22042 USA

[6] Henry Ford Hosp Syst, Dept Med, Sect Cardiovasc Med, Detroit, MI USA

[7] Emory Univ, Sch Med, Dept Med, Sect Cardiovasc Med, Atlanta, GA USA

[8] Yale Univ, Sch Med, Dept Med, Sect Cardiovasc Med, New Haven, CT USA

[9] Tufts Univ, Sch Med, Dept Med, Sect Cardiovasc Med, Boston, MA USA

[10] Brown Univ, Warren Alpert Med Sch, Dept Med, Div Cardiol, Providence, RI USA

[11] Lifespan Cardiovasc Inst, Providence, RI USA

来源：

JACC-HEART FAILURE | 2024年 / 12卷 / 12期

关键词：

acute myocardial infarction; cardiogenic shock; percutaneous coronary intervention; readmissions; volume-outcome relationship; PATIENT-LEVEL ANALYSIS; HOSPITAL VOLUME; OUTCOMES; CARE; ASSOCIATION; PCI; MANAGEMENT; OPERATOR; SIZE;

D O I：

10.1016/j.jchf.2024.07.014

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND There are limited data on volume-outcome relationships in acute myocardial infarction (AMI) with cardiogenic shock (CS). OBJECTIVES In this study, the authors sought to evaluate the association between hospital percutaneous coronary intervention (PCI) volume and readmission after AMI-CS. METHODS Adult AMI-CS patients were identified from the Nationwide Readmissions Database for 2016-2019 and were categorized into hospital quartiles (Q1 lowest volume to Q4 highest) based on annual inpatient PCI volume. Outcomes of interest included 30-day all-cause, cardiac, noncardiac, and heart-failure (HF) readmissions. RESULTS There were 49,558 AMI-CS admissions at 3,954 PCI-performing hospitals. Median annual PCI volume was 174 (Q1-Q3: 70-316). Patients treated at Q1 hospitals were on average older, female, and with higher comorbidity burden. Patients at Q4 hospitals had higher rates of noncardiac organ dysfunction, complications, and use of cardiac support therapies. Overall, 30-day readmission rate was 18.5% (n = 9,179), of which cardiac, noncardiac, and HF readmissions constituted 56.2%, 43.8%, and 25.8%, respectively. From Q1 to Q4, there were no differences in 30-day all-cause (17.6%, 18.4%, 18.2%, 18.7%; P = 0.55), cardiac (10.9%, 11.0%, 10.6%, 10.2%; P = 0.29), and HF (5.0%, 4.8%, 4.8%, 4.8%; P = 0.99) readmissions. Noncardiac readmissions were noted more commonly in higher quartiles (6.7%, 7.4%, 7.7%, 8.5%; P = 0.001) but was not significant after multivariable adjustment. No relationship was noted between hospital PCI volume as a continuous variable and readmissions. CONCLUSIONS In AMI-CS, there was no association between hospital annual PCI volume and 30-day readmissions despite higher acuity in the higher volume PCI centers suggestive of better care pathways for CS at higher volume centers. (JACC Heart Fail. 2024;12:2087-2097) (c) 2024 by the American College of Cardiology Foundation.

引用

页码：2087 / 2097

页数：11