Tummala Ravi, Shah Suchi D, Rawal Era, Sandhu Ramneek K, Kavuri Swathi P, Kaur Gagan, Khan Asma T, Mathialagan Keerthika, Ajibawo Temitope
Internal Medicine, Narayana Medical College, Nellore, IND.
Internal Medicine, Ahmedabad Municipal Corporation's Medical Education Trust Medical College, Ahmedabad, IND.
Cureus. 2021 Aug 28;13(8):e17520. doi: 10.7759/cureus.17520. eCollection 2021 Aug.
Objectives The primary goal of our study is to evaluate the mortality rate in inpatient recipients of multivessel percutaneous coronary intervention (MVPCI) and to evaluate the demographic risk factors and medical complications that increase the risk of in-hospital mortality. Methods We conducted a cross-sectional study using the Nationwide Inpatient Sample (NIS, 2016) and included 127,145 inpatients who received MVPCI as a primary procedure in United States' hospitals. We used a multivariable logistic regression model adjusted for demographic confounders to measure the odds ratio (OR) of association of medical complications and in-hospital mortality risk in MVPCI recipients. Results The in-hospital mortality rate was 2% in MVPCI recipients and was seen majorly in older-age adults (>64 years, 74%) and males (61%). Even though the prevalence of mortality among females was comparatively low, yet in the regression model, they were at a higher risk for in-hospital mortality than males (OR 1.2; 95% CI 1.13-1.37). While comparing ethnicities, in-hospital mortality was prevalent in whites (79%) followed by blacks (9%) and Hispanics (7.5%). Patients who developed cardiogenic shock were at higher odds of in-hospital mortality (OR 9.2; 95% CI 8.27-10.24) followed by respiratory failure (OR 5.9; 95% CI 5.39-6.64) and ventricular fibrillation (OR 3.5; 95% CI 3.18-3.92). Conclusion Accelerated use of MVPCI made it important to study in-hospital mortality risk factors allowing us to devise strategies to improve the utilization and improve the quality of life of these at-risk patients. Despite its effectiveness and comparatively lower mortality profile, aggressive usage of MVPCI is restricted due to the periprocedural complications and morbidity profile of the patients.
目的 我们研究的主要目标是评估多支血管经皮冠状动脉介入治疗(MVPCI)住院患者的死亡率,并评估增加住院死亡率风险的人口统计学危险因素和医学并发症。方法 我们使用全国住院患者样本(NIS,2016)进行了一项横断面研究,纳入了127145例在美国医院接受MVPCI作为主要手术的住院患者。我们使用了一个针对人口统计学混杂因素进行调整的多变量逻辑回归模型,以测量MVPCI接受者中医学并发症与住院死亡风险关联的比值比(OR)。结果 MVPCI接受者的住院死亡率为2%,主要见于老年人(>64岁,74%)和男性(61%)。尽管女性的死亡率相对较低,但在回归模型中,她们的住院死亡风险高于男性(OR 1.2;95% CI 1.13 - 1.37)。在比较不同种族时,住院死亡率在白人中最为普遍(79%),其次是黑人(9%)和西班牙裔(7.5%)。发生心源性休克的患者住院死亡几率更高(OR 9.2;95% CI 8.27 - 10.24),其次是呼吸衰竭(OR 5.9;95% CI 5.39 - 6.64)和心室颤动(OR 3.5;95% CI 3.18 - 3.92)。结论 MVPCI的加速应用使得研究住院死亡风险因素变得很重要,这使我们能够制定策略来提高这些高危患者的利用率并改善其生活质量。尽管MVPCI有效且死亡率相对较低,但由于围手术期并发症和患者的发病情况,其积极应用受到限制。