Impact of Glycoprotein IIb/IIIa Inhibitors Use on Outcomes After Lower Extremity Endovascular Interventions From Nationwide Inpatient Sample (2006-2011).
Impact of Glycoprotein IIb/IIIa Inhibitors Use on Outcomes After Lower Extremity Endovascular Interventions From Nationwide Inpatient Sample (2006-2011).
- 2016
Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006
BACKGROUND: There is paucity of data regarding the impact of GPI on the outcomes following peripheral endovascular interventions. CONCLUSIONS: Multivariate analysis revealed GPI use in peripheral endovascular interventions to be suggestive of an increase in composite end-point of in-hospital mortality and postprocedural complications, no impact on in-hospital mortality alone, significantly lower rate of amputation, and increase in hospitalization costs. © 2016 Wiley Periodicals, Inc. Copyright © 2016 Wiley Periodicals, Inc. METHODS: The study cohort was derived from Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) database between the years 2006 and 2011. Peripheral endovascular interventions and GPI utilization were identified using appropriate ICD-9 Diagnostic and procedural codes. Two-level hierarchical multivariate mixed models were created. The study outcomes were: primary (in-hospital mortality and amputation studied separately) and secondary (composite of in-hospital mortality and postprocedural complications). Hospitalization costs were also assessed. OBJECTIVE: The aim of our study was to study the impact of glycoprotein IIb/IIIa inhibitors (GPI) on in-hospital outcomes. RESULTS: GPI utilization (OR, 95% CI, P-value) was independently predictive of lower amputation rates (0.36, 0.27-0.49, <0.001). There was no significant difference in terms of in-hospital mortality (0.59, 0.31-1.14, P 0.117), although GPI use predicted worse secondary outcomes (1.23, 1.03-1.47, 0.023). Following propensity matching, the amputation rate was lower (3.2% vs. 8%, P<0.001), while hospitalization costs were higher in the cohort that received GPI (
English
1522-1946
*Endovascular Procedures
*Lower Extremity/bs [Blood Supply]
*Peripheral Arterial Disease/th [Therapy]
*Platelet Aggregation Inhibitors/tu [Therapeutic Use]
*Platelet Glycoprotein GPIIb-IIIa Complex/ai [Antagonists & Inhibitors]
Adolescent
Adult
Aged
Aged, 80 and over
Amputation
Cross-Sectional Studies
Databases, Factual
Drug Costs
Endovascular Procedures/ae [Adverse Effects]
Endovascular Procedures/ec [Economics]
Endovascular Procedures/mo [Mortality]
Female
Hospital Costs
Hospital Mortality
Humans
Limb Salvage
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Peripheral Arterial Disease/di [Diagnosis]
Peripheral Arterial Disease/ec [Economics]
Peripheral Arterial Disease/mo [Mortality]
Platelet Aggregation Inhibitors/ae [Adverse Effects]
Platelet Aggregation Inhibitors/ec [Economics]
Propensity Score
Risk Factors
Time Factors
Treatment Outcome
United States
Young Adult
MedStar Heart & Vascular Institute
Journal Article
Observational Study
Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006
BACKGROUND: There is paucity of data regarding the impact of GPI on the outcomes following peripheral endovascular interventions. CONCLUSIONS: Multivariate analysis revealed GPI use in peripheral endovascular interventions to be suggestive of an increase in composite end-point of in-hospital mortality and postprocedural complications, no impact on in-hospital mortality alone, significantly lower rate of amputation, and increase in hospitalization costs. © 2016 Wiley Periodicals, Inc. Copyright © 2016 Wiley Periodicals, Inc. METHODS: The study cohort was derived from Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) database between the years 2006 and 2011. Peripheral endovascular interventions and GPI utilization were identified using appropriate ICD-9 Diagnostic and procedural codes. Two-level hierarchical multivariate mixed models were created. The study outcomes were: primary (in-hospital mortality and amputation studied separately) and secondary (composite of in-hospital mortality and postprocedural complications). Hospitalization costs were also assessed. OBJECTIVE: The aim of our study was to study the impact of glycoprotein IIb/IIIa inhibitors (GPI) on in-hospital outcomes. RESULTS: GPI utilization (OR, 95% CI, P-value) was independently predictive of lower amputation rates (0.36, 0.27-0.49, <0.001). There was no significant difference in terms of in-hospital mortality (0.59, 0.31-1.14, P 0.117), although GPI use predicted worse secondary outcomes (1.23, 1.03-1.47, 0.023). Following propensity matching, the amputation rate was lower (3.2% vs. 8%, P<0.001), while hospitalization costs were higher in the cohort that received GPI (
English
1522-1946
*Endovascular Procedures
*Lower Extremity/bs [Blood Supply]
*Peripheral Arterial Disease/th [Therapy]
*Platelet Aggregation Inhibitors/tu [Therapeutic Use]
*Platelet Glycoprotein GPIIb-IIIa Complex/ai [Antagonists & Inhibitors]
Adolescent
Adult
Aged
Aged, 80 and over
Amputation
Cross-Sectional Studies
Databases, Factual
Drug Costs
Endovascular Procedures/ae [Adverse Effects]
Endovascular Procedures/ec [Economics]
Endovascular Procedures/mo [Mortality]
Female
Hospital Costs
Hospital Mortality
Humans
Limb Salvage
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Peripheral Arterial Disease/di [Diagnosis]
Peripheral Arterial Disease/ec [Economics]
Peripheral Arterial Disease/mo [Mortality]
Platelet Aggregation Inhibitors/ae [Adverse Effects]
Platelet Aggregation Inhibitors/ec [Economics]
Propensity Score
Risk Factors
Time Factors
Treatment Outcome
United States
Young Adult
MedStar Heart & Vascular Institute
Journal Article
Observational Study