Decline in the nationwide trends in in-hospital mortality of patients undergoing multivessel percutaneous coronary intervention.
BACKGROUND
Advances in the safety of percutaneous coronary interventions have been significant in recent years. The goal of this study was to evaluate any decline in the age-adjusted in-hospital mortality rate in patients undergoing multivessel percutaneous coronary intervention (MVPCI) using a very large database from 1988 to 2004 in the United States.


METHODS
The Nationwide Inpatient Sample (NIS) database was utilized to calculate the age-adjusted mortality rate for MVPCI from 1988 to 2004 in patients over the age of 40 years retrospectively. Specific ICD-9-CM codes for MVPCI were used for this study. Patient demographic data were also analyzed and adjusted for age from the database.


RESULTS
The mean age was 71.56 +/- 10.59 years (53.55% male). From 1988 the age-adjusted mortality rate was stable until 1999, with a steady decline to the lowest level in 2004. In 1988, the rate was 67.42 (95% CI = 181-316.14), in 1999 51.02 (95% CI = 27-129.32), and in 2004, 40.06 (95% CI 5.6-85.83) per 100,000. Total death also declined from 1.77% to 1.25%. This trend was similar across gender and ethnicities.


CONCLUSIONS
The age-adjusted mortality from MVPCI was steady until 1999, but declined to the lowest level in 2004. This trend most likely reflects advancements in the care of patients undergoing high-risk coronary interventions.
Movahed
Mohammad Reza
MR
Associate Professor of Medicine, The Southern Arizona VA Health Care System and University of Arizona Sarver Heart Center, 1501 North Campbell Avenue, Tucson, AZ, 85724, USA. rmova@aol.com
Ramaraj
Radhakrishnan
R
Jamal
M Mazen
MM
Hashemzadeh
Mehrtash
M
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods / Q000401:mortality*; D003324:Coronary Artery Disease / Q000628:therapy; D054855:Drug-Eluting Stents; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States