1
|
Grines CL, Box LC, Mamas MA, Abbott JD, Blankenship JC, Carr JG, Curzen N, Kent WDT, Khatib Y, Matteau A, Rymer JA, Schreiber TL, Velagapudi P, Vidovich MI, Waldo SW, Seto AH. SCAI Expert Consensus Statement on Percutaneous Coronary Intervention Without On-Site Surgical Backup. JACC Cardiovasc Interv 2023; 16:847-860. [PMID: 36725479 DOI: 10.1016/j.jcin.2022.12.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Cindy L Grines
- Northside Hospital Cardiovascular Institute, Atlanta, Georgia, USA
| | - Lyndon C Box
- West Valley Medical Center, Caldwell, Idaho, USA
| | | | - J Dawn Abbott
- Rhode Island Hospital, Providence, Rhode Island, USA
| | - James C Blankenship
- The University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | - Jeffrey G Carr
- CardiaStream-Tyler Cardiac and Endovascular Center, Tyler, Texas, USA
| | - Nick Curzen
- University of Southampton, Southampton, United Kingdom
| | - William D T Kent
- Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
| | - Yazan Khatib
- First Coast Cardiovascular Institute, Jacksonville, Florida, USA
| | - Alexis Matteau
- Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | | | | | | | | | - Stephen W Waldo
- Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA
| | - Arnold H Seto
- Long Beach VA Health Care System, Long Beach, California, USA.
| |
Collapse
|
2
|
Grines CL, Box LC, Mamas MA, Abbott JD, Blankenship JC, Carr JG, Curzen N, Kent WD, Khatib Y, Matteau A, Rymer JA, Schreiber TL, Velagapudi P, Vidovich MI, Waldo SW, Seto AH. SCAI Expert Consensus Statement on Percutaneous Coronary Intervention Without On-Site Surgical Backup. JOURNAL OF THE SOCIETY FOR CARDIOVASCULAR ANGIOGRAPHY & INTERVENTIONS 2023; 2:100560. [PMID: 39129815 PMCID: PMC11307489 DOI: 10.1016/j.jscai.2022.100560] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Affiliation(s)
- Cindy L. Grines
- Northside Hospital Cardiovascular Institute, Atlanta, Georgia
| | | | | | | | | | - Jeffrey G. Carr
- CardiaStream-Tyler Cardiac and Endovascular Center, Tyler, Texas
| | - Nick Curzen
- University of Southampton, Southampton, United Kingdom
| | - William D.T. Kent
- Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada
| | - Yazan Khatib
- First Coast Cardiovascular Institute, Jacksonville, Florida
| | - Alexis Matteau
- Centre hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | | | | | | | | | | | - Arnold H. Seto
- Long Beach VA Health Care System, Long Beach, California
| |
Collapse
|
3
|
Afana M, Koenig GC, Seth M, Sukul D, Frazier KM, Fielding S, Jensen A, Gurm HS. Trends and outcomes of non-primary PCI at sites without cardiac surgery on-site: The early Michigan experience. PLoS One 2020; 15:e0238048. [PMID: 32845908 PMCID: PMC7449474 DOI: 10.1371/journal.pone.0238048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/07/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction Non-primary percutaneous coronary intervention (non-PPCI) recently received certificate of need approval in the state of Michigan at sites without cardiac surgery on-site (cSoS). This requires quality oversight through participation in the BMC2 registry. While previous studies have indicated the safety of this practice, real-world comprehensive outcomes, case volume changes, economic impacts, and readmission rates at diverse healthcare centers with and without cSoS remain poorly understood. Methods Consecutive patients undergoing non-PPCI at 47 hospitals (33 cSoS and 14 non-cSoS) in Michigan from April 2016 to March 2018 were included. Using propensity-matching, patients were analyzed to assess outcomes and trends in non-PPCI performance at sites with and without cSOS. Results Of 61,864 PCI’s performed, 50,817 were non-PPCI, with 46,096 (90.7%) performed at sites with cSoS and 4,721 (9.3%) at sites without cSoS. From this cohort, 4,643 propensity-matched patients were analyzed. Rates of major adverse cardiac events (2.6% vs. 2.8%; p = 0.443), in-hospital mortality (0.6% vs. 0.5%; p = 0.465), and several secondary clinical and quality outcomes showed no clinically significant differences. Among a small subset with available post-discharge data, there were no differences in 90-day readmission rates, standardized episode costs, or post-discharge mortality. Overall PCI volume remained stable, with a near three-fold rise in non-PPCI at sites without cSoS. Conclusions Non-PPCI at centers without cardiac SoS was associated with similar comprehensive outcomes, quality of care, 90-day episode costs, and post-discharge mortality compared with surgical sites. Mandatory quality oversight serves to maintain appropriate equivalent outcomes and may be considered for other programs, including the performance of non-PPCI at ambulatory surgical centers in the near future.
Collapse
Affiliation(s)
- Majed Afana
- Division of Cardiovascular Medicine, Henry Ford Health System, Detroit, Michigan, United States of America
| | - Gerald C. Koenig
- Division of Cardiovascular Medicine, Henry Ford Health System, Detroit, Michigan, United States of America
- Wayne State University, School of Medicine, Detroit, Michigan, United States of America
| | - Milan Seth
- Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Devraj Sukul
- Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Kathleen M. Frazier
- Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Sheryl Fielding
- Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Andrea Jensen
- Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Hitinder S. Gurm
- Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, United States of America
- Cardiovascular Medicine, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States of America
- * E-mail:
| |
Collapse
|
4
|
Why a Threshold Case Volume in Complex Systems Such as Thrombectomy in Stroke Care Is Inadequate to Discriminate Quality Outcomes. JACC Cardiovasc Interv 2019; 12:392-394. [PMID: 30784646 DOI: 10.1016/j.jcin.2018.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 12/04/2018] [Indexed: 11/23/2022]
|
5
|
Hannan EL, Zhong Y, Wu Y, Berger PB, Jacobs AK, Walford G, Venditti FJ, Ling FSK, Tamis-Holland J, King SB. Treatment of Coronary Artery Disease and Acute Myocardial Infarction in Hospitals With and Without On-Site Coronary Artery Bypass Graft Surgery. Circ Cardiovasc Interv 2019; 12:e007097. [PMID: 30616362 DOI: 10.1161/circinterventions.118.007097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Many studies have revealed no outcome differences among patients undergoing percutaneous coronary intervention (PCI) in hospitals with and without surgery on-site (SOS), but one earlier study found differences in target vessel PCI rates and in mortality for patients with acute myocardial infarction who did not undergo PCI. It is important to examine outcome differences between SOS and non-SOS hospitals with more contemporary data. METHODS AND RESULTS A total of 21 924 propensity-matched patients who were discharged between January 1, 2013, and November 30, 2015, who were in the New York PCI registry and other hospital databases were used to compare outcomes in hospitals with and without SOS for all patients and for patients with and without ST-segment-elevation myocardial infarction (STEMI) undergoing PCI. Also, 30-day mortality was compared for patients with STEMI regardless of whether they underwent PCI. For all patients with PCI and patients without STEMI, there were no significant differences in in-hospital/30-day mortality, 2-year mortality, or 2-year repeat target lesion PCI. For patients with STEMI, there were no significant mortality differences between patients in SOS and non-SOS hospitals. Patients with STEMI in SOS hospitals had significantly lower 2-year repeat target lesion PCI rates (adjusted hazard ratio, 0.68 [0.49-0.94]). There was no difference in the percentage of patients undergoing PCI in the 2 types of hospitals (75.7% versus 74.6%; P=0.21) or in 30-day mortality of all patients with STEMI (patients who did and did not undergo PCI, 10.86% versus 11.32%; adjusted odds ratio, 1.06 [0.88-1.29]). CONCLUSIONS Short-term and long-term outcomes were not different in SOS and non-SOS hospitals except that 2-year repeat target lesion PCI rates were lower in SOS hospitals for patients with STEMI.
Collapse
Affiliation(s)
- Edward L Hannan
- Cardiac Services Program, University at Albany, State University of New York (E.L.H., Y.Z., Y.W.)
| | - Ye Zhong
- Cardiac Services Program, University at Albany, State University of New York (E.L.H., Y.Z., Y.W.)
| | - Yifeng Wu
- Cardiac Services Program, University at Albany, State University of New York (E.L.H., Y.Z., Y.W.)
| | | | - Alice K Jacobs
- Cardiac Services Program, University at Albany, State University of New York (E.L.H., Y.Z., Y.W.)
| | - Gary Walford
- Cardiac Services Program, University at Albany, State University of New York (E.L.H., Y.Z., Y.W.)
| | - Ferdinand J Venditti
- Cardiac Services Program, University at Albany, State University of New York (E.L.H., Y.Z., Y.W.)
| | - Frederick S K Ling
- Cardiac Services Program, University at Albany, State University of New York (E.L.H., Y.Z., Y.W.)
| | - Jacqueline Tamis-Holland
- Cardiac Services Program, University at Albany, State University of New York (E.L.H., Y.Z., Y.W.)
| | - Spencer B King
- Cardiac Services Program, University at Albany, State University of New York (E.L.H., Y.Z., Y.W.)
| |
Collapse
|