Differences In Short Term In-Hospital Outcomes in Patients Undergoing Percutaneous Coronary Intervention and Coronary Artery Bypass Graft

Background:
Percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) are two of the primary methods of intervention in patients with coronary artery disease. Several studies have previously explored the different predictors of poor outcomes in the usage of PCI and CABG. This study aims to further the understanding of these intervention’s in-hospital outcomes.

Methods:
This study used ICD9 codes and data from the Nationwide Inpatient Sample (2012-15) to identify adults diagnosed with a STEMI who underwent PCI or CABG. Patients missing important clinical identifiers (age, gender, death, race) and if they had both procedures performed were excluded. Hospital length of stay (LOS), total inpatient charges, mortality, and average age at admission were assessed. Pearson’s chi-squared test and independent t-test were used to analyze the data.

Results:
19,824 encounters were identified with a diagnosis of a STEMI and of these 17,460 underwent PCI and 2,355 underwent CABG (average age of 61.6 vs 63.56 p=0.000, respectively). The patients undergoing CABG had a longer length of stay than those in the PCI group (10.33 vs 4.52, 95% CI -6.257 to -5.373: p=0.000). Increased total inpatient charges was observed in those who underwent CABG vs PCI ($194,626 vs $91,588, 95% CI -111,450 to -94,627: p=0.000).

Conclusions:
This study found that patients who were diagnosed with a STEMI and underwent CABG had higher mortality rate, longer length of stay, and more total inpatient charges accumulated than those who had PCI performed. The results of this study can lead to better awareness of factors that may be contributing to the large discrepancy between the two procedures.