Ferreira Roberto Muniz, de Souza E Silva Nelson Albuquerque, Salis Lúcia Helena Alvares
Federal University of Rio de Janeiro, Edson Saad Heart Institute, Rua Rodolpho Paulo Rocco 255, Ilha do Fundão, Rio de Janeiro, RJ 21941-913, Brazil; Samaritano Hospital, Cardiology Department, Rua Bambina 98, Botafogo, Rio de Janeiro, RJ 22251-050, Brazil.
Federal University of Rio de Janeiro, Edson Saad Heart Institute, Rua Rodolpho Paulo Rocco 255, Ilha do Fundão, Rio de Janeiro, RJ 21941-913, Brazil.
Indian Heart J. 2018 Jan-Feb;70(1):32-36. doi: 10.1016/j.ihj.2017.06.012. Epub 2017 Jun 27.
Complications after percutaneous coronary interventions (PCI) are associated with significant morbidity and mortality, although institutional discrepancies can occur when public and private hospitals coexist within the healthcare system. The aim of this study was to compare the in-hospital complication rates and mortality in addition to long-term survival following elective PCI in two reference public and private cardiology hospitals in Rio de Janeiro, Brazil.
From January 1st 2013 to December 31st 2014, a total of 440 procedures were identified in both hospitals (public: 328 vs. private: 112) and retrospectively analyzed by chart review.
There were no significant differences between the two hospitals regarding the total number of procedures with at least one complication (public: 23.8 vs. private: 17.9%, p=0.2) or in-hospital mortality rates (public: 0.6% vs. private: 0%, p=0.5). Post-procedural renal insufficiency was more frequent in the private hospital, whereas coronary-related complications were more prevalent in the public hospital. After a mean follow up of 30.3 months (SD±9.2), the survival rate was also similar.
Clinical complications after elective PCI are common both in public and private hospitals. Meticulous pre-procedural clinical assessment and patient selection as well as adherence to guideline-based practices could minimize the risk of PCI-related adverse events.
经皮冠状动脉介入治疗(PCI)后的并发症与显著的发病率和死亡率相关,尽管在医疗体系中公立和私立医院并存时可能会出现机构差异。本研究的目的是比较巴西里约热内卢两家参考公立和私立心脏病医院择期PCI后的院内并发症发生率、死亡率以及长期生存率。
2013年1月1日至2014年12月31日,两家医院共确定了440例手术(公立:328例 vs. 私立:112例),并通过病历回顾进行回顾性分析。
两家医院在至少有一项并发症的手术总数(公立:23.8% vs. 私立:17.9%,p = 0.2)或院内死亡率(公立:0.6% vs. 私立:0%,p = 0.5)方面无显著差异。术后肾功能不全在私立医院更为常见,而冠状动脉相关并发症在公立医院更为普遍。平均随访30.3个月(标准差±9.2)后,生存率也相似。
择期PCI后的临床并发症在公立和私立医院都很常见。细致的术前临床评估和患者选择以及遵循基于指南的操作可以将PCI相关不良事件的风险降至最低。