In-Hospital Outcomes of PCI in Patients Who Have ESRD vs Non-ESRD Patients, a Retrospective Study Involving a National Inpatient Sample (NIS) Database

Division

North Florida

Hospital

North Florida Regional Medical Center

Document Type

Manuscript

Publication Date

5-26-2023

Keywords

end-stage renal disease, ESRD, NIS, percutaneous coronary intervention, PCI, in-hospital mortality

Disciplines

Cardiovascular Diseases | Female Urogenital Diseases and Pregnancy Complications | Internal Medicine | Male Urogenital Diseases

Abstract

BACKGROUND: Cardiovascular disease is the leading cause of death for patients with end-stage renal disease (ESRD). ESRD is known to affect a large portion of the American population. Previous data for patients undergoing percutaneous coronary intervention (PCI) in the setting of ESRD for Acute Coronary Syndrome (ACS) and non-ACS etiologies have shown to have an increase in in-hospital mortality, and prolonged hospitalization among other complications.

METHODS: The national inpatient sample (NIS) was used to identify patients who underwent PCI between the years 2016-2019. Patients were then grouped into those with ESRD on renal replacement therapy (RRT). Logistic regression models were employed to assess the primary outcome of in-hospital mortality, while linear regression models were utilized to evaluate secondary outcomes, including hospitalization cost and length of stay.

RESULTS: A total of 21,366 unweighted observations were initially included, consisting of 50 % ESRD patients and 50 % randomly selected patients without ESRD who underwent PCI. These observations were weighted to represent a national estimate of 106,830 patients. The mean age of the study population was 65 years, and 63 % of the patients were male. The ESRD group had a greater representation of minority groups compared to the control group. The in-hospital mortality rate was significantly higher in the ESRD group compared to the control group, with an odds ratio of 1.803 (95 % CI: 1.502 to 2.164; p-value of 0.0002). Additionally, the ESRD group had significantly higher healthcare costs and longer length of stay, with a mean difference of $47,618 (95 % CI: $42,701 to $52,534, p-value

CONCLUSION: In-hospital mortality, cost, and length of stay for patients undergoing PCI were found to be significantly greater in the ESRD group.

Publisher or Conference

Cardiovascular Revascularization Medicine

Link to Full Text

Share

COinS