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Temporal changes in co-morbidity burden in patients having percutaneous coronary intervention and impact on prognosis

Temporal changes in co-morbidity burden in patients having percutaneous coronary intervention and impact on prognosis
Temporal changes in co-morbidity burden in patients having percutaneous coronary intervention and impact on prognosis

This study aims to evaluate the impact of co-morbidity burden on outcomes in patients who undergo percutaneous coronary intervention (PCI). We used the Nationwide Inpatient Sample to identify all PCI procedures undertaken in the United States from 2004 to 2014. We then determined co-morbidity burden for each patient record based on the Charlson Co-morbidity Score. Multivariable logistic regression models were used to examine the association between co-morbidity burden and in-hospital mortality other in-hospital complications. A total of 6,601,526 PCI procedures were included in the analysis. Overall co-morbidity burden increased over time, with severe co-morbidity burden (defined as a CCI score ≥3) increasing from 5.3% in 2004 to 14.2% in 2014 (p <0.0001). After adjustment for confounding factors increasing co-morbidity burden was independently associated with increased odds of in-hospital mortality, complications, length of hospital stay, and total cost of hospitalization post PCI. A CCI score of 1 was independently associated with an increase in the odds of in hospital mortality (odds ratio [OR] 1.19 [95% confidence interval [CI] 1.15 to 1.25]), a score of 2 associated with an almost 1.5-fold increase (OR 1.41 [95% CI 1.34 to 1.48]) and a score of ≥3 a 2-fold increase (OR 1.96 [95% CI 1.86 to 2.07]) compared with no co-morbid burden (CCI score of 0). In conclusion, our results show that co-morbid burden is independently associated with increased risk of in-hospital mortality, in-hospital complications, length of stay, and healthcare costs.

0002-9149
712-722
Potts, Jessica
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Kwok, Chun Shing
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Ensor, Joie
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Rashid, Muhammad
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Kadam, Umesh
1d47aee8-72a6-4963-8f45-e0a11edf39e5
Kinnaird, Tim
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Curzen, Nicholas
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Pancholy, Samir B.
b322b0da-0e62-4fbb-88df-993a6315ecb2
Van der Windt, Danielle
a51e943b-e0ed-4aba-9d2d-5e0c7a3e7aee
Riley, Richard D.
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Bagur, Rodrigo
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Mamas, Mamas A.
b71e6a0a-07a4-4822-a10e-c02a6b29ae5d
Potts, Jessica
50e7dd50-d7f6-44a3-8b7d-c1cb5ae8fe7d
Kwok, Chun Shing
000170fb-8506-4c19-9481-e56d93049fef
Ensor, Joie
ef369fc7-8408-4021-8661-f20b0259f8af
Rashid, Muhammad
f974c0d2-bd55-4d93-940e-1cce3dd0fd59
Kadam, Umesh
1d47aee8-72a6-4963-8f45-e0a11edf39e5
Kinnaird, Tim
3cfe5aa5-eb28-4a4d-b2e4-6ea0799d85d0
Curzen, Nicholas
70f3ea49-51b1-418f-8e56-8210aef1abf4
Pancholy, Samir B.
b322b0da-0e62-4fbb-88df-993a6315ecb2
Van der Windt, Danielle
a51e943b-e0ed-4aba-9d2d-5e0c7a3e7aee
Riley, Richard D.
10997621-4f9e-43cd-95d9-cd40cc8ff39c
Bagur, Rodrigo
4afad05d-aab4-48c7-ab89-fa9802123c59
Mamas, Mamas A.
b71e6a0a-07a4-4822-a10e-c02a6b29ae5d

Potts, Jessica, Kwok, Chun Shing, Ensor, Joie, Rashid, Muhammad, Kadam, Umesh, Kinnaird, Tim, Curzen, Nicholas, Pancholy, Samir B., Van der Windt, Danielle, Riley, Richard D., Bagur, Rodrigo and Mamas, Mamas A. (2018) Temporal changes in co-morbidity burden in patients having percutaneous coronary intervention and impact on prognosis. American Journal of Cardiology, 122 (5), 712-722. (doi:10.1016/j.amjcard.2018.05.003).

Record type: Article

Abstract

This study aims to evaluate the impact of co-morbidity burden on outcomes in patients who undergo percutaneous coronary intervention (PCI). We used the Nationwide Inpatient Sample to identify all PCI procedures undertaken in the United States from 2004 to 2014. We then determined co-morbidity burden for each patient record based on the Charlson Co-morbidity Score. Multivariable logistic regression models were used to examine the association between co-morbidity burden and in-hospital mortality other in-hospital complications. A total of 6,601,526 PCI procedures were included in the analysis. Overall co-morbidity burden increased over time, with severe co-morbidity burden (defined as a CCI score ≥3) increasing from 5.3% in 2004 to 14.2% in 2014 (p <0.0001). After adjustment for confounding factors increasing co-morbidity burden was independently associated with increased odds of in-hospital mortality, complications, length of hospital stay, and total cost of hospitalization post PCI. A CCI score of 1 was independently associated with an increase in the odds of in hospital mortality (odds ratio [OR] 1.19 [95% confidence interval [CI] 1.15 to 1.25]), a score of 2 associated with an almost 1.5-fold increase (OR 1.41 [95% CI 1.34 to 1.48]) and a score of ≥3 a 2-fold increase (OR 1.96 [95% CI 1.86 to 2.07]) compared with no co-morbid burden (CCI score of 0). In conclusion, our results show that co-morbid burden is independently associated with increased risk of in-hospital mortality, in-hospital complications, length of stay, and healthcare costs.

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More information

Accepted/In Press date: 16 May 2018
e-pub ahead of print date: 19 June 2018
Published date: 1 September 2018

Identifiers

Local EPrints ID: 428089
URI: http://eprints.soton.ac.uk/id/eprint/428089
ISSN: 0002-9149
PURE UUID: cfc54b9d-5f9b-49bb-9dde-dd59f7b2ad4e
ORCID for Nicholas Curzen: ORCID iD orcid.org/0000-0001-9651-7829

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Date deposited: 08 Feb 2019 17:30
Last modified: 18 Feb 2021 17:04

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Contributors

Author: Jessica Potts
Author: Chun Shing Kwok
Author: Joie Ensor
Author: Muhammad Rashid
Author: Umesh Kadam
Author: Tim Kinnaird
Author: Nicholas Curzen ORCID iD
Author: Samir B. Pancholy
Author: Danielle Van der Windt
Author: Richard D. Riley
Author: Rodrigo Bagur
Author: Mamas A. Mamas

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