Temporal Changes in Comorbidity Burden in Patients Having Percutaneous Coronary Intervention and Impact on Prognosis

Potts, JE; Kwok, CS; Ensor, J; Rashid, M; Kadam, UT; Kinnaird, T; Curzen, N; Pancholy, SB; Van Der Windt, D; Riley, RD; Bagur, R; Mamas, M

Abstract

This study aims to evaluate the impact of comorbidity burden on outcomes among patients who undergo percutaneous coronary intervention (PCI). We used the Nationwide Inpatient Sample to identify all PCI procedures undertaken in the United States between 2004 – 2014. We then determined comorbidity burden for each patient record based on the Charlson Comorbidity Score. Multivariable logistic regression models were used to examine the association between comorbidity burden and in-hospital mortality other in-hospital complications. A total of 6,601,526 PCI procedures were included in the analysis. Overall comorbidity burden increased over time, with severe comorbidity burden (defined as a CCI score =3) increasing from 5.3% in 2004 to 14.2% in 2014 (P<0.0001). After adjustment for confounding factors increasing comorbidity burden was independently associated with increased odds of in-hospital mortality, complications, length of hospital stay and total cost of hospitalisation post PCI. A CCI score of 1 was independently associated with an increase in the odds of in hospital mortality (OR 1.19 (95% CI 1.15-1.25)), a score of 2 associated with an almost 1.5-fold increase (OR 1.41 (95% CI 1.34-1.48)) and a score of =3 a 2-fold increase (OR 1.96 (95% CI 1.86-2.07)) compared to no comorbid burden (CCI score of 0). In conclusion, our results show that comorbid burden is independently associated with increased risk of in-hospital mortality, in-hospital complications, length of stay and healthcare costs.

Citation

Potts, J., Kwok, C., Ensor, J., Rashid, M., Kadam, U., Kinnaird, T., …Mamas, M. (2018). Temporal Changes in Comorbidity Burden in Patients Having Percutaneous Coronary Intervention and Impact on Prognosis. American Journal of Cardiology, 122(5), 712-722. https://doi.org/10.1016/j.amjcard.2018.05.003

• Journal Article Type: Article
• Acceptance Date: May 17, 2018
• Online Publication Date: Jun 19, 2018
• Publication Date: Sep 1, 2018
• Publicly Available Date: May 26, 2023
• Journal: American Journal of Cardiology
• Print ISSN: 0002-9149
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 122
• Issue: 5
• Pages: 712-722
• DOI: https://doi.org/10.1016/j.amjcard.2018.05.003
• Keywords: comorbidity, percutaneous coronary intervention, prognosis
• Publisher URL: https://doi.org/10.1016/j.amjcard.2018.05.003