TY  - BOOK
AU  - Chothani, Ankit
TI  - Impact of symptoms, gender, co-morbidities, and operator volume on outcome of carotid artery stenting (from the Nationwide Inpatient Sample [2006 to 2010])
SN  - 0002-9149
PY  - 2014///
KW  - *Carotid Stenosis/ep [Epidemiology]
KW  - *Inpatients/sn [Statistics & Numerical Data]
KW  - *Risk Assessment/mt [Methods]
KW  - *Stents
KW  - *Stroke/ep [Epidemiology]
KW  - *Vascular Surgical Procedures/ut [Utilization]
KW  - Aged
KW  - Carotid Stenosis/su [Surgery]
KW  - Comorbidity/td [Trends]
KW  - Female
KW  - Follow-Up Studies
KW  - Hospital Mortality/td [Trends]
KW  - Humans
KW  - Length of Stay/td [Trends]
KW  - Male
KW  - Postoperative Period
KW  - Prognosis
KW  - Registries
KW  - Retrospective Studies
KW  - Risk Factors
KW  - Sex Factors
KW  - Survival Rate/td [Trends]
KW  - United States/ep [Epidemiology]
KW  - MedStar Washington Hospital Center
KW  - Medicine/General Internal Medicine
KW  - Journal Article
KW  - Multicenter Study
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - The increase in the number of carotid artery stenting (CAS) procedures over the last decade has necessitated critical appraisal of procedural outcomes and patterns of utilization including cost analysis. The main objectives of our study were to evaluate the postprocedural mortality and complications after CAS and the patterns of resource utilization in terms of length of stay (LOS) and cost of hospitalization. We queried the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample from 2006 to 2010 using the International Classification of Diseases, Ninth Revision, procedure code of 00.63 for CAS. Hierarchical mixed-effects models were generated to identify the independent multivariate predictors of in-hospital mortality, procedural complications, LOS, and cost of hospitalization. A total of 13,564 CAS procedures (weighted n = 67,344) were analyzed. The overall postprocedural mortality was low at 0.5%, whereas the complication rate was 8%, both of which remained relatively steady over the time frame of the study. Greater postoperative mortality and complications were noted in symptomatic patients, women, and those with greater burden of baseline co-morbidities. A greater operator volume was associated with a lower rate of postoperative mortality and complications, as well as shorter LOS and lesser hospitalization costs. In conclusion, the postprocedural mortality after CAS has remained low over the recent years. Operator volume is an important predictor of postprocedural outcomes and resource utilization. Copyright  2014 Elsevier Inc. All rights reserved
UR  - http://dx.doi.org/10.1016/j.amjcard.2014.06.030
ER  -