title: In-hospital outcomes after elective and non-elective percutaneous coronary interventions in hospitals with and without on-site cardiac surgery backup.
abstract: BACKGROUND
  Guidelines recommend on-site surgery backup (SB) when elective percutaneous coronary intervention (PCI) is performed. The evidence for this recommendation is however weak.
  
  
  OBJECTIVE
  The objective of the present study was to compare clinical outcomes in patients undergoing PCI in hospitals with SB or without surgery backup (non-SB).
  
  
  METHODS
  Prospective German PCI registry in 36 hospitals throughout Germany. Consecutive procedures were collected and analyzed centrally.
  
  
  RESULTS
  In 2006, a total of 23,148 patients were included; 12,465 patients (53.8%) in 11 hospitals with SB and 10,683 patients (46.2%) in 25 hospitals without on-site cardiac SB. Both patient groups were well-balanced with regard to age and gender. SB hospitals had more patients with ACS (OR 1.29; 95%CI 1.23-1.36) and less patients with stable angina (OR 0.78; 95%CI 0.74-0.82) than non-SB hospitals. There was no indication of a clinically relevant differential outcome for in-hospital death, MACE, non-fatal MI, non-fatal stroke/TIA, or emergency CABG between SB and non-SB hospitals for neither patients with ACS nor stable angina except for emergency CABG in ACS patients (more frequent in SB hospitals, OR 2.29; 95%CI 1.02-5.13).
  
  
  CONCLUSIONS
  There was no evidence of an excess risk associated with PCI-procedures performed in non-SB hospitals.
authors: Klinikum Lippe GmbH, Fachbereich Herz-Kreislauf, 32756 Detmold, Germany. ulrich.tebbe@klinikum-lippe.de
authors: Ulrich
authors: U
authors: Tebbe
authors: Matthias
authors: M
authors: Hochadel
authors: Peter
authors: P
authors: Bramlage
authors: Sebastian
authors: S
authors: Kerber
authors: Rainer
authors: R
authors: Hambrecht
authors: Eberhard
authors: E
authors: Grube
authors: Karl E
authors: KE
authors: Hauptmann
authors: Martin
authors: M
authors: Gottwik
authors: Albrecht
authors: A
authors: Elsässer
authors: Hans-Georg
authors: HG
authors: Glunz
authors: Tassilo
authors: T
authors: Bonzel
authors: Jörg
authors: J
authors: Carlsson
authors: Uwe
authors: U
authors: Zeymer
authors: Ralf
authors: R
authors: Zahn
authors: Jochen
authors: J
authors: Senges
mesh_terms: D054058:Acute Coronary Syndrome / Q000628:therapy*; D000368:Aged; D000787:Angina Pectoris / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D017558:Elective Surgical Procedures; D005260:Female; D005858:Germany; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012042:Registries; D013503:Surgery Department, Hospital; D016896:Treatment Outcome