Many PCI Operators Performing Fewer PCIs Than Recommended
In-hospital mortality up for procedures performed by low-, intermediate- versus high-volume operators
THURSDAY, June 15, 2017 (HealthDay News) -- Many U.S. percutaneous coronary intervention (PCI) operators are performing fewer than the recommended number of PCI procedures, according to a study published in the June 20 issue of the Journal of the American College of Cardiology.
Alexander C. Fanaroff, M.D., from Duke University in Durham, N.C., and colleagues used data from the National Cardiovascular Data Registry to examine operator annual PCI volume. Operators were divided in low- (<50 PCIs per year), intermediate- (50 to 100 PCIs per year), and high- volume (>100 PCIs per year) groups.
The researchers found that the median annual number of procedures performed was 59 per operator; 44 percent of operators performed fewer than 50 PCI procedures per year. For low-, intermediate-, and high-volume operators, the unadjusted in-hospital mortality was 1.86, 1.73, and 1.48 percent, respectively. The adjusted risk of in-hospital mortality was increased for PCI procedures performed by low- and intermediate-volume operators versus high-volume operators (adjusted odds ratios, 1.16 and 1.05 for low and intermediate versus high, respectively); similar results were seen for the risk of new dialysis post-PCI. There was no volume relationship seen for post PCI bleeding.
"Although absolute risk differences are small and may be partially explained by unmeasured differences in case mix between operators, there remains an inverse relationship between PCI operator volume and in-hospital mortality that persisted in risk-adjusted analyses," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.