title: Ten years of percutaneous coronary intervention in a low-volume military treatment facility: a quality improvement project.
abstract: BACKGROUND
  The quality assurance of a percutaneous coronary intervention (PCI) program is particularly important when the volume of procedures is low in the center.
  
  
  OBJECTIVE
  Determine predictors of the 30-day and long-term incidence of stent thrombosis, myocardial infarction, and death from any cause for all PCIs performed at Tripler Army Medical Center from January 2002 to June 2012.
  
  
  METHODS
  929 PCIs were performed in 795 patients, resulting in an average PCI volume of 88 per year. Follow-up data were obtained for 99.8% of the patients at 30 days and for 83% at 3 years.
  
  
  RESULTS
  18 deaths occurred during the first 30 days after PCI, with an observed morality rate of 2.26%. Multivariate logistic regression identified independent predictors of death at 30 days: stent thrombosis (OR 96), acute myocardial infarction, hemodynamic instability (OR 47), emergent (OR 17) or salvage (OR 28) PCI, and the need for preprocedural balloon pumping (OR 27). The long-term survival Kaplan-Meier estimates were 94% at 1 year and 90.4% at 3 years.
  
  
  CONCLUSIONS
  The 30-day mortality was similar to the expected mortality based on the risk factors in the New York State Registry model, and long-term survival was comparable with that reported in large registries.
authors.affiliation: Tripler Army Medical Center, 1 Jarrett White Road, ATTN: MCHK-DM, Honolulu, Hawaii 96859-5000, USA.
authors.forename: Emilio
authors.initials: E
authors.lastname: Fentanes
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Wisenbaugh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D061846:Hospitals, Low-Volume / Q000592:standards*; D006772:Hospitals, Military / Q000592:standards*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008887:Military Medicine; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality* / Q000592:standards; D011785:Quality Assurance, Health Care; D058996:Quality Improvement; D015607:Stents / Q000009:adverse effects; D015996:Survival Rate; D013927:Thrombosis / Q000453:epidemiology / Q000209:etiology; D014481:United States / Q000453:epidemiology