title: Multivessel Percutaneous Coronary Interventions in the United States: Insights From the Nationwide Inpatient Sample.
abstract: BACKGROUND
  Multivessel coronary artery disease carries significant mortality risk. Comprehensive data on inhospital outcomes following multivessel percutaneous coronary intervention (MVPCI) are sparse.
  
  
  METHODS
  We queried the Healthcare Cost and Utilization Project's nationwide inpatient sample (NIS) between 2006 and 2011 using different International Classification of Diseases, 9th Revision, Clinical Modification procedure codes. The primary outcome was inhospital all-cause mortality, and the secondary outcome was a composite of inhospital mortality and periprocedural complications.
  
  
  RESULTS
  The overall mortality was low at 0.73% following MVPCI. Multivariate analysis revealed that (odds ratio, 95% confidence interval, P value) age (1.63, 1.48-1.79; <.001), female sex (1.19, 1.00-1.42; P = .05), acute myocardial infarction (AMI; 2.97, 2.35-3.74; <.001), shock (17.24, 13.61-21.85; <.001), a higher burden of comorbidities (2.09, 1.32-3.29; .002), and emergent/urgent procedure status (1.67, 1.30-2.16; <.001) are important predictors of primary and secondary outcomes. MVPCI was associated with higher mortality, length of stay (LOS), and cost of care as compared to single vessel single stent PCI.
  
  
  CONCLUSIONS
  MVPCI is associated with higher inhospital mortality, LOS, and hospitalization costs compared to single vessel, single stent PCI. Higher volume hospitals had lower overall postprocedural mortality rate along with shorter LOS and lower hospitalization costs following MVPCI.
authors.affiliation: Internal Medicine Department, Mount Sinai St Luke's Roosevelt Hospital, New York, NY, USA.
authors.forename: Shilpkumar
authors.initials: S
authors.lastname: Arora
authors.affiliation: Cardiovascular Department, Detroit Medical Center, Detroit, MI, USA.
authors.forename: Sidakpal S
authors.initials: SS
authors.lastname: Panaich
authors.affiliation: Internal Medicine Department, Staten Island University Hospital, Staten Island, NY, USA.
authors.forename: Nileshkumar J
authors.initials: NJ
authors.lastname: Patel
authors.affiliation: Internal Medicine Department, Saint Peter's University Hospital, New Brunswick, NJ, USA.
authors.forename: Nilay
authors.initials: N
authors.lastname: Patel
authors.affiliation: Internal Medicine Department, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Shantanu
authors.initials: S
authors.lastname: Solanki
authors.affiliation: Cardiology Department, Mayo Clinic, Rochester, MN, USA.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Deshmukh
authors.affiliation: Cardiology Department, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Vikas
authors.initials: V
authors.lastname: Singh
authors.affiliation: Internal Medicine Department, Mount Sinai Hospital Center, New York, NY, USA.
authors.forename: Sopan
authors.initials: S
authors.lastname: Lahewala
authors.affiliation: Internal Medicine Department, New York Medical College, Valhalla, NY, USA.
authors.forename: Chirag
authors.initials: C
authors.lastname: Savani
authors.affiliation: Internal Medicine Department, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA, USA.
authors.forename: Badal
authors.initials: B
authors.lastname: Thakkar
authors.affiliation: Internal Medicine Department, Texas A&M University, College Station, TX, USA.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Dave
authors.affiliation: Internal Medicine Department, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Achint
authors.initials: A
authors.lastname: Patel
authors.affiliation: Internal Medicine Department, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA, USA.
authors.forename: Parth
authors.initials: P
authors.lastname: Bhatt
authors.affiliation: Internal Medicine Department, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sonani
authors.affiliation: Internal Medicine Department, Lankenau Institute for Medical Research, Wynnewood, PA, USA.
authors.forename: Aashay
authors.initials: A
authors.lastname: Patel
authors.affiliation: Cardiology Department, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Cleman
authors.affiliation: Cardiology Department, Yale School of Medicine, New Haven, CT, USA.
authors.forename: John K
authors.initials: JK
authors.lastname: Forrest
authors.affiliation: Cardiovascular Department, Detroit Medical Center, Detroit, MI, USA.
authors.forename: Theodore
authors.initials: T
authors.lastname: Schreiber
authors.affiliation: Cardiology Department, Yale School of Medicine, New Haven, CT, USA apurva.badheka@yale.edu.
authors.forename: Apurva O
authors.initials: AO
authors.lastname: Badheka
authors.affiliation: Cardiovascular Department, Detroit Medical Center, Detroit, MI, USA.
authors.forename: Cindy
authors.initials: C
authors.lastname: Grines
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000401:mortality*; D015607:Stents / Q000009:adverse effects; D014481:United States; D055815:Young Adult
keywords: hospital volume; mortality; multivessel percutaneous coronary interventions