Document Detail


Clinical and economic outcomes of coronary angioplasty alone or in combination with stents in academic health centers: a retrospective database analysis.
MedLine Citation:
PMID:  16464189     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Indications for the use of stents are evolving and their optimal place in therapy remains to be defined. The objective was to compare the 1-year clinical and economic outcomes of percutaneous transluminal coronary agioplasty (PTCA) with and without the use of stents. METHODS: This retrospective database analysis was conducted using data from 60 US academic medical centers in 1996 and 1997. Outcomes of interest included in-hospital mortality (both on sentinel and readmission visits), readmission rates, revascularization procedures, length of stay, and the cost of sentinel and readmission hospitalization. RESULTS: A total of 27,020 patients either did (n = 13,254) or did not (n = 13,766) receive coronary stents in conjunction with PTCA. The median cost of hospitalization for the stent group was about dollar 1,409 higher (mean, dollar 1,200) than the no-stent group and the length of stay was similar (4.3 days vs. 4.5 days, respectively, P = .2628). Mortality rates on readmission (0.9% stent vs. 0.8% no-stent, P = NS) did not differ. However, patients in the stent group had better mortality rates compared to the no-stent group during the sentinel visit (1.7% vs. 2.7%, P < .001). Stent use was not associated with a significantly lower risk of a revascularization procedure on readmission to the same institution (OR 0.95, 95% CI 0.87-1.04, P = .28). CONCLUSIONS: Stents were associated with a 1% decrease of inpatient mortality during the sentinel visit without impacting length of stay or readmission rates. This advantage was associated with a dollar 1,409 higher median cost of hospitalization in the stent group.
Authors:
M J Oinonen; K S Akhras; C Chen; K A Matuszewski; P H Vlasses
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research     Volume:  3     ISSN:  1098-3015     ISO Abbreviation:  Value Health     Publication Date:    2000 Jul-Aug
Date Detail:
Created Date:  2006-02-08     Completed Date:  2006-03-02     Revised Date:  2006-11-07    
Medline Journal Info:
Nlm Unique ID:  100883818     Medline TA:  Value Health     Country:  United States    
Other Details:
Languages:  eng     Pagination:  253-60     Citation Subset:  -    
Affiliation:
Clinical Practice Advancement Center, University HealthSystem Consortium, Oak Brook, IL 60523, USA. oinonen@uhc.edu
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