Trends in Utilization and Safety of In-Hospital Coronary Artery Bypass Grafting During a Non-ST-Segment Elevation Myocardial Infarction
Section snippets
Methods
The data were drawn from the NIS, the Healthcare Cost and Utilization Project, and Agency for Healthcare Research and Quality (AHRQ).6 The NIS datasets include only de-identified data; therefore, this study was deemed exempt from institutional review by the Human Research Committee.
The NIS is the largest collection of all-payer data on in-patient hospitalizations in the United States. The dataset represents an approximate 20% stratified sample of all inpatient discharges from US hospitals.7
Results
Out of 98,754,774 unweighted hospitalizations in the NIS database during the 1/2003 to 9/2015 period, a total of 91,673 hospitalizations were included in the analysis based on the inclusion criteria described above. After implementing the weighting method, these represented an estimated total of 440,371 hospitalizations for NSTEMI, in patients who underwent in-hospital CABG during the index hospitalization. The majority of patients (70.7%) were male and the mean age of the cohort was 65 years.
Discussion
Utilizing data from the NIS, the largest all-payer inpatient database in the United States, we identified a weighted total of 440,371 patients, who underwent CABG during their hospitalization for NSTEMI. The data show a relatively steady utilization of CABG in NSTEMI patients during the study period (2003 to 2015). That trend is consistent with previous studies that demonstrated modest increases in utilization of in-hospital CABG in NSTEMI patients during the early 1990s, remaining relatively
Author Contribution
Gabby Elbaz-Greener—study design, data interpretation, drafting the manuscript; Guy Rozen—conceptualization, drafting the manuscript; Fabio Kusniec—data analysis, data interpretation; Ibrahim Marai—data analysis, data interpretation; Diab Ghanim—critical revision of the manuscript; Shemy Carasso—critical revision of the manuscript, supervision, Yulia Gavrilov—methodology, data interpretation; Maneesh Sud—data interpretation, drafting the manuscript; Bradley Strauss—critical revision of the
Disclosures
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgment
The corresponding author affirms that he has listed everyone who contributed significantly to the work. The corresponding author had access to all the study data, took responsibility for the accuracy of the analysis, and had authority over manuscript preparation and the decision to submit the manuscript for publication. The corresponding author confirms that all authors read and approve the manuscript.
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Funding: None.
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These authors contributed equally to this study and manuscript preparation.