title: Frequency of percutaneous coronary interventions at facilities without on-site cardiac surgical backup--a report from the American College of Cardiology-National Cardiovascular Data Registry (ACC-NCDR).
abstract: The practice of performing percutaneous coronary intervention (PCI) in centers without on-site cardiac surgical backup is controversial. Using data from facilities that participated in the American College of Cardiology/National Cardiovascular Data Registry, the incidence of PCI without on-site surgical backup was evaluated. From January 1, 2001 through December 31, 2004, 39 of 449 (8.7%) centers were identified as sites that performed PCI without on-site surgical backup. By the end of 2005, 75 of 463 (16%) participating facilities were performing PCI without on-site backup. By using standardized data element definitions, it was possible to differentiate between patients who underwent elective PCI and those who had urgent nonelective PCI for acute ST-segment elevation myocardial infarction or non-ST-segment elevation myocardial infarction. This analysis showed that the number of elective and nonelective PCI procedures with or without on-site surgical backup per quarter had increased significantly (p <0.0001) from 2001 to 2004. The number of PCI procedures performed without on-site surgical backup continued to increase in 2005. In conclusion, the significant increase in elective PCIs performed at facilities without on-site surgical backup occurred despite national guidelines that state elective PCI should not be done in centers without on-site cardiac surgery.
authors.affiliation: Texas A&M University College of Medicine and Cardiology Division, Scott & White Clinic, Temple, Texas, USA. gdehmer@swmail.sw.org
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Dehmer
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kutcher
authors.forename: Syamal K
authors.initials: SK
authors.lastname: Dey
authors.forename: Richard E
authors.initials: RE
authors.lastname: Shaw
authors.forename: William S
authors.initials: WS
authors.lastname: Weintraub
authors.forename: Kristi
authors.initials: K
authors.lastname: Mitchell
authors.forename: Ralph G
authors.initials: RG
authors.lastname: Brindis
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy*; D012017:Referral and Consultation / Q000458:organization & administration*; D012042:Registries / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013903:Thoracic Surgery / Q000458:organization & administration*; D014481:United States