title: Age and sex differences in inhospital complication rates and mortality after percutaneous coronary intervention procedures: evidence from the NCDR(®).
abstract: BACKGROUND
  Older women experience higher complication rates and mortality after percutaneous coronary intervention (PCI) than men, but there is limited evidence about sex-based differences in outcomes among younger patients. We compared rates of complications and inhospital mortality by sex for younger and older PCI patients.
  
  
  METHODS
  A total of 1,079,751 hospital admissions for PCI were identified in the CathPCI Registry(®) from 2005 to 2008. Complication rates (general, bleeding, bleeding with transfusion, and vascular) and inhospital mortality after PCI were compared by sex and age (<55 and ≥55 years). Analyses were adjusted for demographic and clinical factors and stratified by PCI type (elective, urgent, or emergency).
  
  
  RESULTS
  Overall, 6% of patients experienced complications, and 1% died inhospital. Unadjusted complication rates were higher for women compared with men in both age groups. In risk-adjusted analyses, younger women (odds ratio 1.24, 95% CI 1.16-1.33) and older women (1.27, 1.09-1.47) were more likely to experience any complication than similarly aged men. The increased risk persisted across complication categories and PCI type. Within age groups, risk-adjusted mortality was marginally higher for young women (1.19, 1.00-1.41), but not for older women (1.03, 0.97-1.10). In analyses stratified by PCI type, young women had twice the mortality risk after an elective procedure as young men (2.04, 1.15-3.61).
  
  
  CONCLUSIONS
  Women, regardless of age, experience more complications after PCI than men; young women are at increased mortality risk after an elective PCI. Identifying strategies to reduce adverse outcomes, particularly for women younger than 55 years, is important.
authors.affiliation: Yale School of Public Health, New Haven, CT; Yale-New Haven Hospital Center for Outcomes Research and Evaluation, New Haven, CT. Electronic address: Judith.Lichtman@yale.edu.
authors.forename: Judith H
authors.initials: JH
authors.lastname: Lichtman
authors.affiliation: Yale-New Haven Hospital Center for Outcomes Research and Evaluation, New Haven, CT.
authors.forename: Yongfei
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Yale School of Public Health, New Haven, CT.
authors.forename: Sara B
authors.initials: SB
authors.lastname: Jones
authors.affiliation: Yale School of Public Health, New Haven, CT.
authors.forename: Erica C
authors.initials: EC
authors.lastname: Leifheit-Limson
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
authors.forename: Leslee J
authors.initials: LJ
authors.lastname: Shaw
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
authors.forename: Viola
authors.initials: V
authors.lastname: Vaccarino
authors.affiliation: Denver VA Medical Center, Denver, CO.
authors.forename: John S
authors.initials: JS
authors.lastname: Rumsfeld
authors.affiliation: Yale School of Public Health, New Haven, CT; Yale-New Haven Hospital Center for Outcomes Research and Evaluation, New Haven, CT; Yale School of Medicine, New Haven, CT.
authors.forename: Harlan M
authors.initials: HM
authors.lastname: Krumholz
authors.affiliation: Yale-New Haven Hospital Center for Outcomes Research and Evaluation, New Haven, CT; Yale School of Medicine, New Haven, CT.
authors.forename: Jeptha P
authors.initials: JP
authors.lastname: Curtis
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000628:therapy*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000401:mortality*; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology