Predicting vascular complications in percutaneous coronary interventions
| Autor: | John F. Robb, David J. Malenka, Thomas J. Ryan, Paul D McGrath, Mary S Corliss, Michael J. Hearne, Theodore M Silver, Karen L Farrell, Bruce D. Hettleman, David E. Wennberg, John R O’Mears, Matthew W. Watkins, Mirle A. Kellett, William A. Bradley, Gerald T. O'Connor, Samuel J. Shubrooks, Winthrop D Piper |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Male
medicine.medical_specialty Percutaneous medicine.medical_treatment Coronary Disease Body Mass Index Sex Factors Risk Factors Internal medicine Angioplasty medicine Odds Ratio Humans Myocardial infarction Registries Vascular Diseases Angioplasty Balloon Coronary Coronary Artery Bypass Aged Retrospective Studies Body surface area Aged 80 and over Analysis of Variance Vascular disease business.industry Retrospective cohort study Odds ratio Middle Aged medicine.disease Surgery ROC Curve Conventional PCI Cardiology Feasibility Studies Female Stents Cardiology and Cardiovascular Medicine business |
| Zdroj: | American heart journal. 145(6) |
| ISSN: | 1097-6744 |
| Popis: | Objectives Using a large, current, regional registry of percutaneous coronary interventions (PCI), we identified risk factors for postprocedure vascular complications and developed a scoring system to estimate individual patient risk. Background A vascular complication (access-site injury requiring treatment or bleeding requiring transfusion) is a potentially avoidable outcome of PCI. Methods Data were collected on 18,137 consecutive patients undergoing PCI in northern New England from January 1997 to December 1999. Multivariate regression was used to identify characteristics associated with vascular complications and to develop a scoring system to predict risk. Results The rate of vascular complication was 2.98% (541 cases). Variables associated with increased risk in the multivariate analysis included age ≥70, odds ratio (OR) 2.7, female sex (OR 2.4), body surface area 2 (OR 1.9), history of congestive heart failure (OR 1.4), chronic obstructive pulmonary disease (OR 1.5), renal failure (OR 1.9), lower extremity vascular disease (OR 1.4), bleeding disorder (OR 1.68), emergent priority (OR 2.3), myocardial infarction (OR 1.7), shock (1.86), ≥1 type B2 (OR 1.32) or type C (OR 1.7) lesions, 3-vessel PCI (OR 1.5), use of thienopyridines (OR 1.4) or use of glycoprotein IIb/IIIa receptor inhibitors (OR 1.9). The model performed well in tests for significance, discrimination, and calibration. The scoring system captured 75% of actual vascular complications in its highest quintiles of predicted risk. Conclusion Predicting the risk of post-PCI vascular complications is feasible. This information may be useful for clinical decision-making and institutional efforts at quality improvement. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect