000			03806nam a22005777a 4500
008			141125s20142014 xxu||||| |||| 00| 0 eng d
022			_a0002-9149
040			_aOvid MEDLINE(R)
099			_a25208563
245			_aImpact of symptoms, gender, co-morbidities, and operator volume on outcome of carotid artery stenting (from the Nationwide Inpatient Sample [2006 to 2010]).
251			_aAmerican Journal of Cardiology. 114(6):933-41, 2014 Sep 15.
252			_aAm J Cardiol. 114(6):933-41, 2014 Sep 15.
253			_aThe American journal of cardiology
260			_c2014
260			_fFY2015
266			_d2014-11-25
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520			_aThe 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.
546			_aEnglish
650			_a*Carotid Stenosis/ep [Epidemiology]
650			_a*Inpatients/sn [Statistics & Numerical Data]
650			_a*Risk Assessment/mt [Methods]
650			_a*Stents
650			_a*Stroke/ep [Epidemiology]
650			_a*Vascular Surgical Procedures/ut [Utilization]
650			_aAged
650			_aCarotid Stenosis/su [Surgery]
650			_aComorbidity/td [Trends]
650			_aFemale
650			_aFollow-Up Studies
650			_aHospital Mortality/td [Trends]
650			_aHumans
650			_aLength of Stay/td [Trends]
650			_aMale
650			_aPostoperative Period
650			_aPrognosis
650			_aRegistries
650			_aRetrospective Studies
650			_aRisk Factors
650			_aSex Factors
650			_aSurvival Rate/td [Trends]
650			_aUnited States/ep [Epidemiology]
651			_aMedStar Washington Hospital Center
656			_aMedicine/General Internal Medicine
657			_aJournal Article
657			_aMulticenter Study
700			_aChothani, Ankit
790			_aArora S, Badheka AO, Brown M, Chothani A, Deshmukh A, Elder M, Grines C, Grover P, Kaki A, Kondur A, Mehta K, Mohamad T, Panaich SS, Panchal V, Patel A, Patel N, Patel NJ, Savani CN, Schreiber T, Shah N, Singh V
856			_uhttp://dx.doi.org/10.1016/j.amjcard.2014.06.030 _zhttp://dx.doi.org/10.1016/j.amjcard.2014.06.030
942			_cART _dArticle
999			_c1165 _d1165