Percutaneous Coronary Interventions Outcomes in Octogenarians Patients

Background:
Despite increased utilization of percutaneous coronary intervention (PCI), octogenarian patients are less likely to be referred to the catheterization laboratory for coronary interventions. This is mainly due to multiple comorbidities and lack of guidelines. In this study, we aim to compare in-hospital outcomes of octogenarian patients undergoing PCI in the U.S.

Methods:
Using the National Inpatient Sample (NIS) database, we identified all adult patients who were older than 18 years and underwent PCI. Patient were stratified by age into two groups, ≥80 years old and <80 years old.

Results:
A total of 11,056,559 patients who underwent PCI between the years 2002 to 2014 were identified. Out of 11,056,559 patients, 9,511,996 were <80 years old (86%) and 1,544,563 patients were ≥80 years old (14%). After multivariate adjustment, patients who are ≥80 years old had higher in-hospital mortality (3.3% vs 1.3%, adjusted Odds Ratio [aOR], 1.624; 95% confidence interval [CI], 1.602-1.647, P<0.0001), longer length of stay (median 3 days, range 2-8 days) (median 2 days, range 1-4 days) (P<0.0001) and higher rate of cardiac complications (3.4% vs. 2.4% aOR 1.074; 95% CI 1.061-1.087; p < 0.0001), respiratory complications (2.8% vs. 2.1% aOR 0.923; 95% CI 0.911-0.935; adjusted p < 0.0001), post-procedural stroke (6.3% vs. 3.8% aOR 1.323; 95% CI 1.323-1.335; p < 0.0001), and acute kidney injury (8.9% vs. 4.6% aOR 1.520; 95% CI 1.507-1.533; adjusted p < 0.0001).

Conclusions:
Age is an independent risk factor for patients undergoing PCI. Overall, octogenarians who underwent PCI were at increased risk for in-hospital mortality and morbidity compared to non-elderly.