Variation in practice for out-of-hospital cardiac arrest treated with percutaneous coronary intervention in England and Wales
Variation in practice for out-of-hospital cardiac arrest treated with percutaneous coronary intervention in England and Wales
Objectives: We assessed the association between total center volume, operator volume, and out-of-hospital cardiac arrest (OHCA) percutaneous coronary intervention (PCI) volume. Background: Variations between OHCA PCI volume, hospital total PCI, and primary PCI volume are not well studied and are unlikely to be clinically justifiable. Methods: Patients undergoing PCI for the acute coronary syndrome (ACS) between January 1, 2014, and March 31, 2019, in England and Wales were grouped as OHCA PCI and non-OHCA PCI. Spearman's correlation was used to determine the degree of correlation between each hospital PCI volume and OHCA PCI volume. Results: Out of 250,088 PCI procedures undertaken for ACS, 12,016 (4.8%) were performed for OHCA, and 238,072 (95.2%) were non-OHCA PCI procedures. The OHCA PCI group were younger [mean age (SD) 63.2 (12.3) and 65.6 (12.5, p < 0.001)], less likely to be female (20.2% vs. 26.9%, p < 0.001) or Black, Asian, and Minority Ethnicity (11.5% vs. 14.8%, p < 0.001) compared to the non-OHCA PCI group. Although there was a degree of correlation between total PCI and OHCA PCI, there was wide variation for both ACS cohort (Spearman correlation R
2 = 0.50) and total PCI volume (Spearman correlation R
2 = 0.60). Furthermore, the correlation between primary PCI volume and OHCA PCI within centers was weak (R
2 = 0.10). Similarly, wide variations between operator PCI volume and OHCA PCI volume were observed. Conclusion: These national data demonstrate wide variation in the practice of OHCA PCI both between centers and individuals. These variations are not expected according to clinical factors and require further investigation.
mortality, out of hospital cardiac arrest, outcomes, percutaneous coronary intervention, predictors
306-316
Muhammad, Rashid
e7cf9f70-52c8-47ff-9672-18012bb21a3e
Kinnaird, Tim
d2c13271-5311-4156-9945-e42e98fdfcd3
Ludman, Peter
28ef305d-e09e-40a7-84b4-6ccedfb37cc8
Keeble, Thomas
59d1fda3-79bb-4a49-a938-9cba092ec621
Mamas, Mamas
41515b72-75ff-4922-bb9f-8f9c63f9f5af
Curzen, Nicholas
70f3ea49-51b1-418f-8e56-8210aef1abf4
1 September 2022
Muhammad, Rashid
e7cf9f70-52c8-47ff-9672-18012bb21a3e
Kinnaird, Tim
d2c13271-5311-4156-9945-e42e98fdfcd3
Ludman, Peter
28ef305d-e09e-40a7-84b4-6ccedfb37cc8
Keeble, Thomas
59d1fda3-79bb-4a49-a938-9cba092ec621
Mamas, Mamas
41515b72-75ff-4922-bb9f-8f9c63f9f5af
Curzen, Nicholas
70f3ea49-51b1-418f-8e56-8210aef1abf4
Muhammad, Rashid, Kinnaird, Tim, Ludman, Peter, Keeble, Thomas, Mamas, Mamas and Curzen, Nicholas
(2022)
Variation in practice for out-of-hospital cardiac arrest treated with percutaneous coronary intervention in England and Wales.
Catheterization and Cardiovascular Interventions, 100 (3), .
(doi:10.1002/ccd.30316).
Abstract
Objectives: We assessed the association between total center volume, operator volume, and out-of-hospital cardiac arrest (OHCA) percutaneous coronary intervention (PCI) volume. Background: Variations between OHCA PCI volume, hospital total PCI, and primary PCI volume are not well studied and are unlikely to be clinically justifiable. Methods: Patients undergoing PCI for the acute coronary syndrome (ACS) between January 1, 2014, and March 31, 2019, in England and Wales were grouped as OHCA PCI and non-OHCA PCI. Spearman's correlation was used to determine the degree of correlation between each hospital PCI volume and OHCA PCI volume. Results: Out of 250,088 PCI procedures undertaken for ACS, 12,016 (4.8%) were performed for OHCA, and 238,072 (95.2%) were non-OHCA PCI procedures. The OHCA PCI group were younger [mean age (SD) 63.2 (12.3) and 65.6 (12.5, p < 0.001)], less likely to be female (20.2% vs. 26.9%, p < 0.001) or Black, Asian, and Minority Ethnicity (11.5% vs. 14.8%, p < 0.001) compared to the non-OHCA PCI group. Although there was a degree of correlation between total PCI and OHCA PCI, there was wide variation for both ACS cohort (Spearman correlation R
2 = 0.50) and total PCI volume (Spearman correlation R
2 = 0.60). Furthermore, the correlation between primary PCI volume and OHCA PCI within centers was weak (R
2 = 0.10). Similarly, wide variations between operator PCI volume and OHCA PCI volume were observed. Conclusion: These national data demonstrate wide variation in the practice of OHCA PCI both between centers and individuals. These variations are not expected according to clinical factors and require further investigation.
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BCIS OHCA CCI non tracked
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Accepted/In Press date: 4 June 2022
e-pub ahead of print date: 29 June 2022
Published date: 1 September 2022
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Funding Information:
The authors are solely responsible for this study design and conduct and all analysis, drafting, and editing of the manuscript and its final content.
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© 2022 Wiley Periodicals LLC.
Keywords:
mortality, out of hospital cardiac arrest, outcomes, percutaneous coronary intervention, predictors
Identifiers
Local EPrints ID: 468304
URI: http://eprints.soton.ac.uk/id/eprint/468304
ISSN: 1522-1946
PURE UUID: 558543eb-2e62-497d-87c5-996d0f0065ea
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Date deposited: 09 Aug 2022 17:06
Last modified: 17 Mar 2024 07:24
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Author:
Rashid Muhammad
Author:
Tim Kinnaird
Author:
Peter Ludman
Author:
Thomas Keeble
Author:
Mamas Mamas
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