Percutaneous coronary intervention rate and cost comparison based on presenting diagnosis of coronary artery disease.
Mansoor Ahmad, M.D., OSF Saint Francis Medical Center, Peoria, IL
Mansoor Ahmad, M.D.1, Muhammad N Asghar, MD2, Nathan A Neilson2, Michael Y Tye3, Pablo Barzallo, MD4, Matthew J Kerr5, Tiaranesha K Jackson5, Brett C Austin5, Minchul Kim, PhD6, Marco Barzallo, M.D., FACC7 and Sudhir Mungee, M.D., FACC, FSCAI5, (1)OSF Saint Francis Medical Center, Peoria, IL, (2)OSF St. Francis Medical Center/UICOMP, Peoria, IL, (3)OSF Saint Francis Medical Center, Peoria, Illinois, (4)UICOMP, Peoria, IL, (5)university of illinois college of medicine at peoria, Peoria, IL, (6)UIC, Peoria, IL, (7)OSF Cardiovascular Institute, Peoria, IL
Keywords: Coronary and Quality
Background:
The high prevalence of coronary artery disease (CAD) is leading to increasing numbers of coronary interventions and health care costs. We report the clinical outcome and the cost effectiveness of PCI.
Methods:
It is a retrospective analysis of 7388 patients who had coronary angiogram at our facility from January 2015 to December, 2017. Patients were identified from CathPCI registry. We excluded patients with incomplete records and those who needed CABG. Patients were divided in two groups based on PCI requirements. Cost analysis was based on CAD presentation types (No symptoms, atypical symptoms, stable angina, unstable angina, NSTEMI, STEMI). Primary outcomes were 30-day readmission and death. Secondary outcome was admission cost.
Results:
After exclusion, final sample size was 6403. Average age was 65.6 years (SD: 12.5; Male: 63.8%). 2444 required PCI (38%; p<0.001). PCI group had comparatively younger patients (62.5 years; SD: 12.3, p<0.001) with significantly lower BMI (30.6 vs 31.1, p=0.015). PCI rate increased significantly with severity of CAD presentation type (Table:1). PCI group had significantly lower odds for 30-day readmission (OR: 0.63; CI: 0.45-0.89; p=0.009) and 30-day mortality (OR:0.60; CI: 0.41-0.89; p=0.011). Odds of PCI increase with severity of CAD presentation type (Table-2). Cost was significantly high in PCI group for all CAD presentation types (Table-3).
Conclusions:
Odds of PCI increase with severity of CAD presentation type. The primary outcome of mortality and 30 day readmission rates were better in PCI patients compared with non-PCI patients. The admission cost was significantly higher in PCI group.
