Comparison of Inhospital Outcomes and Hospitalization Costs of Peripheral Angioplasty and Endovascular Stenting.

MedStar author(s):
Citation: American Journal of Cardiology. 116(4):634-41, 2015 Aug 15.PMID: 26096999Institution: MedStar Washington Hospital CenterDepartment: Medicine/General Internal MedicineForm of publication: Journal ArticleMedline article type(s): Comparative Study | Journal ArticleSubject headings: *Angioplasty/sn [Statistics & Numerical Data] | *Health Care Costs | *Hospitalization/ec [Economics] | *Peripheral Arterial Disease/su [Surgery] | *Stents/sn [Statistics & Numerical Data] | Adolescent | Adult | Aged | Aged, 80 and over | Angioplasty/ae [Adverse Effects] | Angioplasty/ec [Economics] | Cohort Studies | Databases, Factual | Female | Hospital Mortality | Hospitalization/sn [Statistics & Numerical Data] | Humans | Male | Middle Aged | Peripheral Arterial Disease/ec [Economics] | Peripheral Arterial Disease/mo [Mortality] | Propensity Score | Stents/ae [Adverse Effects] | Stents/ec [Economics] | Treatment Outcome | United States/ep [Epidemiology] | Young AdultYear: 2015Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 0002-9149
Name of journal: The American journal of cardiologyAbstract: The comparative data for angioplasty and stenting for treatment of peripheral arterial disease are largely limited to technical factors such as patency rates with sparse data on clinical outcomes like mortality, postprocedural complications, and amputation. The study cohort was derived from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database from 2006 to 2011. Peripheral endovascular interventions were identified using appropriate International Classification of Diseases, Ninth Revision (ICD-9) Diagnostic and procedural codes. Two-level hierarchical multivariate mixed models were created. The primary outcome includes inhospital mortality, and secondary outcome was a composite of inhospital mortality and postprocedural complications. Amputation was a separate outcome. Hospitalization costs were also assessed. Endovascular stenting (odds ratio, 95% confidence interval, p value) was independently predictive of lower composite end point of inhospital mortality and postprocedural complications compared with angioplasty alone (0.96, 0.91 to 0.99, 0.025) and lower amputation rates (0.56, 0.53 to 0.60, <0.001) with no significant difference in terms of inhospital mortality alone. Multivariate analysis also revealed stenting to be predictive of higher hospitalization costs (All authors: Arora S, Attaran RR, Badheka AO, Bhatt P, Bhimani R, Chothani A, Cleman M, Curtis JP, Deshmukh A, Forrest JK, Grines C, Jhamnani S, Lahewala S, Manvar S, Mavani K, Mena CI, Mohamad T, Panaich SS, Patel A, Patel J, Patel N, Patel NJ, Patel SV, Remetz MS, Savani C, Savani GT, Singh V, Solanki S, Thakkar B, Tripathi BFiscal year: FY2016Digital Object Identifier: Date added to catalog: 2016-01-13
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 26096999 Available 26096999

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006

The comparative data for angioplasty and stenting for treatment of peripheral arterial disease are largely limited to technical factors such as patency rates with sparse data on clinical outcomes like mortality, postprocedural complications, and amputation. The study cohort was derived from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database from 2006 to 2011. Peripheral endovascular interventions were identified using appropriate International Classification of Diseases, Ninth Revision (ICD-9) Diagnostic and procedural codes. Two-level hierarchical multivariate mixed models were created. The primary outcome includes inhospital mortality, and secondary outcome was a composite of inhospital mortality and postprocedural complications. Amputation was a separate outcome. Hospitalization costs were also assessed. Endovascular stenting (odds ratio, 95% confidence interval, p value) was independently predictive of lower composite end point of inhospital mortality and postprocedural complications compared with angioplasty alone (0.96, 0.91 to 0.99, 0.025) and lower amputation rates (0.56, 0.53 to 0.60, <0.001) with no significant difference in terms of inhospital mortality alone. Multivariate analysis also revealed stenting to be predictive of higher hospitalization costs ( ,516, 95% confidence interval 1,082 to 1,950, p <0.001) compared with angioplasty. In conclusion, endovascular stenting is associated with a lower rate of postprocedural complications, lower amputation rates, and only minimal increase in hospitalization costs compared with angioplasty alone. Copyright � 2015 Elsevier Inc. All rights reserved.

English

Powered by Koha