In-Hospital Mortality for Inpatient Percutaneous Coronary Interventions in the United States
Section snippets
Methods
We used the 2016 National Inpatient Sample (NIS) database developed for the Healthcare Cost and Utilization Project by the Agency for Healthcare Research and Quality.14 This is a publicly available all-payer inpatient healthcare database that includes data from more than 7 million hospital stays annually and is designed to project nationally representative estimates of US inpatient hospitalizations. NIS excluded rehabilitation and long-term care facilities.
The 2016 NIS database included
Results
We identified 80,793 unweighted inpatient hospitalizations for PCI, which project 371,430 (±7,175) US admissions for PCI. The average age for this population was 64.8 (±0.07) years, with 248,830 (±4,900) admissions for men (67.0%) and 122,600 (±2,443) admissions for women (33.0%).
Of the 371,430 admissions, there were 108.9 (±2.2) admissions per 100,000 US population from urban hospitals and 152.9 (±6.3) per 100,000 US population from rural hospitals (Figure 1). The average age for patients
Discussion
We find that rural and urban hospitals have similar rates of in-hospital mortality after inpatient PCI. As rural hospitals previously had higher in-hospital mortality-rates, this demonstrates a substantial improvement in PCI care. However, we did find that within urban centers substantial differences in care exist—with nonteaching hospitals having substantially higher rates of mortality. 41% of urban inpatient hospitalizations for PCI were for NSTEMI events and 3% for STEMI events, compared
Disclosures
The authors have no competing interests to report.
Acknowledgment
We would like to acknowledge HCUP and their partners for their contributions to the NIS database. A full list of partners can be found at https://www.hcup-us.ahrq.gov/db/hcupdatapartners.jsp.
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Cited by (2)
Disparities in Urgent Cardiovascular Care in the United States
2023, Cardiovascular Revascularization MedicineInvasive Management and In-Hospital Outcomes of Myocardial Infarction Patients in Rural Versus Urban Hospitals in the United States
2023, Cardiovascular Revascularization MedicineCitation Excerpt :On the other hand, those with cardiac arrest complicating AMI appeared to be fare better in rural centres than in urban teaching hospitals (In-hospital mortality aOR 1.36, 95 % CI 1.32–1.39, p < 0.001) in another NIS study [7], however this is likely due to more severe cases surviving to hospital presentation in the urban compared to the rural settings as discussed above. A recently published analysis from the 2016 NIS database found no difference in adjusted in-hospital mortality between rural and urban centres following PCI [16]. However, there are three caveats in comparison to this paper.
Funding: No funding was used for this study.