title: Out-of-hospital deaths within 30 days following hospitalization where percutaneous coronary intervention was performed.
abstract: Much has been learned about predictors of in-hospital death after percutaneous coronary intervention (PCI), but little is known about the predictors of short-term death after discharge. This is particularly important for PCI, with its short postprocedural hospitalization and concern about postprocedural events such as stent thrombosis and need for emergency cardiac surgery. The focus of this study was all 51,695 patients who underwent PCI in New York State from January 1, 2007, and December 31, 2007, who were discharged alive by December 31, 2007. All patients were followed for 30 days after discharge to determine if they died after discharge within 30 days. The in-hospital and 30-day mortality rate for PCI patients was 0.94%, the in-hospital mortality rate was 0.56%, and the mortality rate for deaths that occurred after discharge within 30 days of the procedure was 0.38%. Of the PCI deaths that occurred either in the index admission or after discharge within 30 days, 40.5% occurred after discharge. The percentage of short-term (in-hospital or within 30 days) deaths in hospitals with ≥10 short-term deaths ranged from 15% to 71%. In conclusion, compared to PCI patients dying in the index admission, patients who died <30 days after discharge were younger, had better ventricular function, were less likely to have had recent myocardial infarctions, and were less likely to have had postprocedural complications. Most deaths in the 30-day group were cardiovascular, and most were cardiac and acute. A small percentage were related to chronic cardiac disease or to vascular disease.
authors.affiliation: Department of Health Policy, Management, and Behavior, University at Albany School of Public Health, New York, USA. elh03@health.state.ny.us
authors.forename: Edward L
authors.initials: EL
authors.lastname: Hannan
authors.forename: Michael
authors.initials: M
authors.lastname: Racz
authors.forename: Gary
authors.initials: G
authors.lastname: Walford
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D009518:New York / Q000453:epidemiology; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome