title: Risk predictors for adverse outcomes after percutaneous coronary interventions and their related costs.
abstract: OBJECTIVE
  During recent years, numerous clinical and procedural risk factors for adverse outcomes after percutaneous coronary interventions (PCI) have been identified. Due to the high economic pressure in many national health care systems, it is of some interest whether these predictors of clinical risks represent also the main cost drivers.
  
  
  METHODS
  Data of 770 patients undergoing PCI were retrospectively analyzed. Risk factors for PCI as well as angiographic classifications were adopted from the ACC/AHA Guidelines. In-hospital costs for each patient were obtained from thoroughly performed calculations for the national Diagnosis Related Groups database in Germany.
  
  
  RESULTS
  Creatinine >2 mg/dl (192% of average costs, P < 0.0001), EF <or= 35% (146%, P < 0.0001), presence of a thrombus (146%, P < 0.0001), PCI of a venous bypass (143%, P < 0.0001), CCS class IV (123%, P < 0.0001), coronary three-vessel disease (119%, P < 0.0001) and age (112%, P = 0.014) were associated with both higher in-hospital mortality and costs. Furthermore, in patients with acute coronary syndromes the time delay from onset of symptoms until PCI had marked impact on costs.
  
  
  CONCLUSIONS
  Most predictors for adverse outcome after PCI were also found to be major cost drivers. Moreover, time delay from onset of ACS to PCI had marked impact on costs and should be implemented in the reimbursement systems.
authors.affiliation: Hospital of the University of Münster, Münster, Germany.
authors.forename: Michele
authors.initials: M
authors.lastname: Pohlen
authors.forename: Holger
authors.initials: H
authors.lastname: Bunzemeier
authors.forename: Wibke
authors.initials: W
authors.lastname: Husemann
authors.forename: Norbert
authors.initials: N
authors.lastname: Roeder
authors.forename: Günter
authors.initials: G
authors.lastname: Breithardt
authors.forename: Holger
authors.initials: H
authors.lastname: Reinecke
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000191:economics*; D003327:Coronary Disease / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D003365:Costs and Cost Analysis; D003404:Creatinine / Q000097:blood; D005260:Female; D005858:Germany / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome
chemical_list: D003404:Creatinine