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Clin Res Cardiol. 2009 Nov;98(11):701-7. doi: 10.1007/s00392-009-0045-x. Epub 2009 Jul 14.

In-hospital outcomes after elective and non-elective percutaneous coronary interventions in hospitals with and without on-site cardiac surgery backup.

Author information

  • 1Klinikum Lippe GmbH, Fachbereich Herz-Kreislauf, 32756 Detmold, Germany. ulrich.tebbe@klinikum-lippe.de

Abstract

BACKGROUND:

Guidelines recommend on-site surgery backup (SB) when elective percutaneous coronary intervention (PCI) is performed. The evidence for this recommendation is however weak.

OBJECTIVES:

The objective of the present study was to compare clinical outcomes in patients undergoing PCI in hospitals with SB or without surgery backup (non-SB).

METHODS:

Prospective German PCI registry in 36 hospitals throughout Germany. Consecutive procedures were collected and analyzed centrally.

RESULTS:

In 2006, a total of 23,148 patients were included; 12,465 patients (53.8%) in 11 hospitals with SB and 10,683 patients (46.2%) in 25 hospitals without on-site cardiac SB. Both patient groups were well-balanced with regard to age and gender. SB hospitals had more patients with ACS (OR 1.29; 95%CI 1.23-1.36) and less patients with stable angina (OR 0.78; 95%CI 0.74-0.82) than non-SB hospitals. There was no indication of a clinically relevant differential outcome for in-hospital death, MACE, non-fatal MI, non-fatal stroke/TIA, or emergency CABG between SB and non-SB hospitals for neither patients with ACS nor stable angina except for emergency CABG in ACS patients (more frequent in SB hospitals, OR 2.29; 95%CI 1.02-5.13).

CONCLUSIONS:

There was no evidence of an excess risk associated with PCI-procedures performed in non-SB hospitals.

PMID:
19597756
[PubMed - indexed for MEDLINE]
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