In-hospital outcomes and readmission in older adults treated with percutaneous coronary intervention for stable ischemic heart disease
Dae Yong Park1
Jonathan M.Hanna2
Sumeet Kadian3
Mannat Kadian4
W.Schuyler Jones5
Abdulla Al Damluji6
Ajar Kochar7
Jeptha P.Curtis8
Michael G.Nanna8
1.Department of Medicine,Cook County Health,Chicago,IL,USA2.Department of Internal Medicine,Yale School of Medicine,New Haven,CT,USA3.University of Connecticut,Storrs,CT,USA4.East Lyme High School,East Lyme,CT,USA5.Section of Interventional Cardiology,Duke University Health System,Durham,NC,USA6.Section of Interventional Cardiology,Johns Hopkins University,Baltimore,MD,USA7.Section of Interventional Cardiology,Brigham and Women's Hospital,Boston,MA,USA8.Section of Cardiovascular Medicine,Yale School of Medicine,New Haven,CT,USA
摘要：Background Percutaneous coronary intervention (PCI) for stable ischemic heart disease (SIHD) in older adults requires a metic-ulous assessment of procedural risks and benefits, but contemporary data on outcomes in this population is lacking. Therefore, we examined the risk of near-term readmission, bleeding, and mortality in high-risk cohort of older adults undergoing inpatient PCI for SIHD. METHODS We analyzed the National Readmissions Database from 2017 to 2018 to identify index hospitalizations in which PCI was performed for SIHD. Patients were stratified into those ≥ 75 years old (older adults) and those < 75 years old. The primary outcome was 90-day readmission. Secondary outcomes included in-hospital mortality, hospital length of stay (LOS), and total hospital charge. RESULTS A total of 74,516 patients underwent inpatient PCI for SIHD, of whom 24,075 were older adults. Older adult patients had higher odds of in-hospital mortality (OR = 2.00, 95％ CI: 1.68-2.38), intracranial hemorrhage (OR = 2.03, 95％ CI: 1.24-3.34), and gastrointestinal hemorrhage (OR = 1.72, 95％ CI: 1.43-2.07) during index hospitalization, with longer LOS and in-hospital charge. Older adults also experienced a higher hazard of 90-day readmission for any cause (HR = 1.61, 95％ CI: 1.57-1.66) and car-diovascular causes (HR = 1.84, 95％ CI: 1.77-1.91). CONCLUSION Older adults undergoing inpatient PCI for SIHD were at increased risk for in-hospital mortality, periprocedural morbidities, higher cost, and readmissions compared with younger adults. Understanding these differences may improve shared decision-making for patients with SIHD being considered for PCI.
机标关键词：percutaneousstableheartwithadultscoronarydiseasein-hospital
论文发表日期：2022-09-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：12( 631-642 )