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In-hospital outcomes after elective and non-elective percutaneous coronary interventions in hospitals with and without on-site cardiac surgery backup |
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| Authors: | Ulrich Tebbe Matthias Hochadel Peter Bramlage Sebastian Kerber Rainer Hambrecht Eberhard Grube Karl E Hauptmann Martin Gottwik Albrecht Elsässer Hans-Georg Glunz Tassilo Bonzel Jörg Carlsson Uwe Zeymer Ralf Zahn Jochen Senges |
| Institution: | 1. Klinikum Lippe GmbH, Fachbereich Herz-Kreislauf, R?ntgenstrasse 18, 32756, Detmold, Germany 2. Stiftung Institut für Herzinfarktforschung Ludwigshafen an der Universit?t Heidelberg, Ludwigshafen, Germany 3. Institut für kardiovaskul?re Pharmakologie und Epidemiologie, Mahlow, Germany 4. Herz- und Gef??klinik GmbH, Bad Neustadt, Germany 5. Krankenhaus Links der Weser, Bremen, Germany 6. Helios Klinikum Siegburg, Siegburg, Germany 7. Krankenhaus der Barmherzigen Brüder, Trier, Germany 8. Klinikum Nürnberg Süd, Medizinische Klinik 8, Nürnberg, Germany 9. St?dt. Kliniken Oldenburg, Oldenburg, Germany 10. Westpfalz-Klinikum GmbH, Standort I Kaiserlautern, Kaiserlautern, Germany 11. Klinikum Fulda, Fulda, Germany 12. L?nssjukhuset i Kalmar, Lasarettsv?gen, Kalmar, Sweden 13. Herzzentrum Ludwigshafen, Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen, Germany |
| Abstract: | BackgroundGuidelines recommend on-site surgery backup (SB) when elective percutaneous coronary intervention (PCI) is performed. The evidence for this recommendation is however weak.ObjectivesThe objective of the present study was to compare clinical outcomes in patients undergoing PCI in hospitals with SB or without surgery backup (non-SB).MethodsProspective German PCI registry in 36 hospitals throughout Germany. Consecutive procedures were collected and analyzed centrally.ResultsIn 2006, a total of 23,148 patients were included; 12,465 patients (53.8%) in 11 hospitals with SB and 10,683 patients (46.2%) in 25 hospitals without on-site cardiac SB. Both patient groups were well-balanced with regard to age and gender. SB hospitals had more patients with ACS (OR 1.29; 95%CI 1.23–1.36) and less patients with stable angina (OR 0.78; 95%CI 0.74–0.82) than non-SB hospitals. There was no indication of a clinically relevant differential outcome for in-hospital death, MACE, non-fatal MI, non-fatal stroke/TIA, or emergency CABG between SB and non-SB hospitals for neither patients with ACS nor stable angina except for emergency CABG in ACS patients (more frequent in SB hospitals, OR 2.29; 95%CI 1.02–5.13).ConclusionsThere was no evidence of an excess risk associated with PCI-procedures performed in non-SB hospitals. |
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