title: Coronary procedures in German hospitals: a detailed analysis for specific patient clusters.
abstract: OBJECTIVE
  Evaluation of the classification of the patients with coronary procedures [CP: coronary angiography (CA) and/or percutaneous coronary intervention (PCI)] in Germany to provide valid data as a basis for the evaluation of resource planning and comparison of results from other countries.
  
  
  BACKGROUND
  In the case of CP, most data are restricted to procedures related to acute coronary syndrome (ACS), either STEMI or NSTEMI, and does not cover the whole range of coronary angiographies and therapeutic procedures. To contribute to the clarification of this situation, our analysis was performed.
  
  
  METHODS
  The data of all patients with CP documented according to § 137 German Social Security Code V (SGB V) by hospitals registered under the requirements of § 108 SGB V were analyzed. By cluster analysis, the most important predictors for four short-term clinical outcomes (intra-procedural and post-procedural events, death, length of hospital stay) were identified. Differences were analyzed on a national, federal state and interstate level.
  
  
  RESULTS
  In 2012, 764,233 CP were performed in 733,337 patients (64.7 % males) in 890 hospitals. In 88.2 % of all patients, a cardiac disease was detected; in 11.3 %, it was excluded. 5 clusters were identified which were based on the following parameters: ACS, invasive coronary procedure, cardiac disease (i.e., hypertensive cardiac disease, cardiomyopathy, aortic aneurysm, cardiac valve disease), exclusion of CHD. There were significant differences between the five patient clusters: percentages of patients with diabetes, renal insufficiency and CHF varied between 14.1 and 32.9 %, 9.5 and 31.6 %, and 7.0 and 16.9 %, respectively; average duration of hospitalization and death rates varied between 5.5 (without ACS) and 8 days (ACS) and 0.3 and 4.5 %, respectively. The distribution of patient clusters varied significantly between the German federal states as well as within a federal state.
  
  
  CONCLUSIONS
  Five patient clusters with CP showed significantly differing profiles of risk, outcome and resource consumption as well as a regional distribution. This has to be considered for comparisons between hospitals as well as on a regional and international level and hospital planning.
authors: Institut für klinische Pharmakologie, TU Dresden, Fiedlerstr. 27, 01307, Dresden, Germany, kurt.bestehorn@googlemail.com.
authors: Kurt
authors: K
authors: Bestehorn
authors: Timm
authors: T
authors: Bauer
authors: Eckart
authors: E
authors: Fleck
authors: Maike
authors: M
authors: Bestehorn
authors: Jürgen
authors: J
authors: Pauletzki
authors: Christian
authors: C
authors: Hamm
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D016000:Cluster Analysis; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000401:mortality* / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate; D016896:Treatment Outcome; D014600:Utilization Review
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