Document Detail


Cause of in-hospital death in 12,232 consecutive patients undergoing percutaneous transluminal coronary angioplasty. The Northern New England Cardiovascular Disease Study Group.
MedLine Citation:
PMID:  10223894     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Some deaths after percutaneous coronary angioplasty (PTCA) occur in high-risk situations (eg, shock), whereas others are unexpected and related to procedural complications. To better describe the epidemiologic causes of death after PTCA, we undertook a systematic review of all in-hospital PTCA deaths in Northern New England from 1990 to 1993. METHODS: The medical records of 121 patients who died during their acute hospitalization for PTCA were reviewed with a standardized data extraction tool to determine a mode of death (eg, low output failure, arrhythmia, respiratory failure) and a circumstance of death (eg, death attributable to a procedural complication, preexisting acute cardiac disease). Any death not classified as a procedural complication was reviewed by a committee and the circumstance of death assigned by a majority rule. RESULTS: Low-output failure was the most common mode of death occurring in 80 (66.1%) of 121 patients. Other modes of death included ventricular arrhythmias (10.7%), stroke (4.1%), preexisting renal failure (4.1%), bleeding (2.5%), ventricular rupture (2.5%), respiratory failure (2.5%), pulmonary embolism (1.7%), and infection (1.7%). The circumstance of death was a procedural complication in 65 patients (53.7%) and a preexisting acute cardiac condition in 41 patients (33.9%). Women were more likely to die of a procedural complication than were men. CONCLUSION: Procedural complications account for half of all post-PTCA deaths and are a particular problem for women. Other deaths are more directly related to patient acuity or noncardiac, comorbid conditions. Understanding why women face an increased risk of procedural complications may lead to improved outcomes for all patients.
Authors:
D J Malenka; D O'Rourke; M A Miller; M J Hearne; S Shubrooks; M A Kellett; J F Robb; J R O'Meara; P VerLee; W A Bradley; D Wennberg; T Ryan; P T Vaitkus; B Hettleman; M W Watkins; P D McGrath; G T O'Connor
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  American heart journal     Volume:  137     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-04-27     Completed Date:  1999-04-27     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  632-8     Citation Subset:  AIM; IM    
Affiliation:
Sections of Cardiology and Clinical Research, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA. david.malenka@hitchcock.org
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary / mortality*
Cause of Death*
Coronary Disease / therapy*
Female
Hospital Mortality*
Humans
Male
Medical Records
Middle Aged
New England / epidemiology
Retrospective Studies
Sex Factors
Comments/Corrections
Comment In:
Am Heart J. 1999 Apr;137(4 Pt 1):582-4   [PMID:  10097214 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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