| Title |
In-Hospital Outcomes of Percutaneous Coronary Intervention in America’s Safety Net Insights From the NCDR Cath-PCI Registry
|
|---|---|
| Published in |
JACC: Cardiovascular Interventions, August 2017
|
| DOI | 10.1016/j.jcin.2017.05.042 |
| Pubmed ID | |
| Authors |
Tushar Acharya, Adam C. Salisbury, John A. Spertus, Kevin F. Kennedy, Amarbir Bhullar, H. Kiran K. Reddy, Bipin K. Joshi, John A. Ambrose |
| Abstract |
This study compared risk-adjusted percutaneous coronary intervention (PCI) outcomes of safety-net hospitals (SNHs) and non-SNHs. Although risk adjustment is used to compare hospitals, SNHs treat a disproportionate share of uninsured and underinsured patients, who may have unmeasured risk factors, limited health care access, and poorer outcomes than patients treated at non-SNHs. Using the National Cardiovascular Data Registry CathPCI Registry from 2009 to 2015, we analyzed 3,746,961 patients who underwent PCI at 282 SNHs (hospitals where ≥10% of PCI patients were uninsured) and 1,134 non-SNHs. The relationship between SNH status and risk-adjusted outcomes was assessed. SNHs were more likely to be lower volume, rural hospitals located in the southern states. Patients treated at SNHs were younger (63 vs. 65 years), more often nonwhite (17% vs. 12%), smokers (33% vs. 26%), and more likely to be admitted through the emergency department (48% vs. 38%) and to have an ST-segment elevation myocardial infarction (20% vs. 14%) than non-SNHs (all p < 0.001). Patients undergoing PCI at SNHs had higher risk-adjusted in-hospital mortality (odds ratio: 1.23; 95% confidence interval: 1.17 to 1.32; p < 0.001), although the absolute risk difference between groups was small (0.4%). Risk-adjusted bleeding (odds ratio: 1.05; 95% confidence interval: 1.00 to 1.12; p = 0.062) and acute kidney injury rates (odds ratio: 1.01; 95% confidence interval: 0.96 to 1.07; p = 0.51) were similar. Despite treating a higher proportion of uninsured patients with more acute presentations, risk-adjusted PCI-related in-hospital mortality of SNHs is only marginally higher (4 additional deaths per 1,000 PCI cases) than non-SNHs, whereas risk-adjusted bleeding and acute kidney injury rates are comparable. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 39 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 39 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 4 | 10% |
| Researcher | 4 | 10% |
| Student > Ph. D. Student | 3 | 8% |
| Student > Postgraduate | 3 | 8% |
| Student > Bachelor | 2 | 5% |
| Other | 5 | 13% |
| Unknown | 18 | 46% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 6 | 15% |
| Social Sciences | 4 | 10% |
| Nursing and Health Professions | 3 | 8% |
| Biochemistry, Genetics and Molecular Biology | 1 | 3% |
| Economics, Econometrics and Finance | 1 | 3% |
| Other | 2 | 5% |
| Unknown | 22 | 56% |
Attention Score in Context
This research output has an Altmetric Attention Score of 112. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 August 2017.
All research outputs
#374,319
of 25,382,440 outputs
Outputs from JACC: Cardiovascular Interventions
#47
of 4,032 outputs
Outputs of similar age
#7,983
of 327,503 outputs
Outputs of similar age from JACC: Cardiovascular Interventions
#2
of 91 outputs
Altmetric has tracked 25,382,440 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,032 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 15.2. This one has done particularly well, scoring higher than 98% of its peers.
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We're also able to compare this research output to 91 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 97% of its contemporaries.