Published in:
01-11-2009 | Original Paper
In-hospital outcomes after elective and non-elective percutaneous coronary interventions in hospitals with and without on-site cardiac surgery backup
Published in: Clinical Research in Cardiology | Issue 11/2009
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Background
Guidelines recommend on-site surgery backup (SB) when elective percutaneous coronary intervention (PCI) is performed. The evidence for this recommendation is however weak.
Objectives
The objective of the present study was to compare clinical outcomes in patients undergoing PCI in hospitals with SB or without surgery backup (non-SB).
Methods
Prospective German PCI registry in 36 hospitals throughout Germany. Consecutive procedures were collected and analyzed centrally.
Results
In 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).
Conclusions
There was no evidence of an excess risk associated with PCI-procedures performed in non-SB hospitals.