Research Explores Volume Changes in Procedure-Associated Complications
April 1, 2009 - Cardiac Data Solutions’ research findings presented at ACC this week report that the number of revascularization procedures, related in-hospital mortality and some complications among Medicare beneficiaries decreased between 2003 and 2006, while at the same time, rates of infection and acute respiratory distress syndrome (ARDS) following coronary artery bypass graft (CABG) surgery increased.
According to the study, the number of hospitalizations for CABG declined 7.4 percent annually from 2003 to 2006. The number of hospitalizations for percutaneous coronary intervention (PCI) decreased 2.3 percent annually from 2004 to 2006 after peaking in 2003. It has yet to be determined if the volume decreases, which were unexpected given the aging population, are due to anti-smoking activities, improvements in medical management, and/or increased use of drug-eluting stents.
During the study period, average annual in-hospital mortality decreased 4.9 percent for CABG and 7.6 percent for PCI procedures. Researchers also reported statistically significant decreases in complications including post-operative stroke among CABG patients and vascular complications for PCI patients; additionally, the rate of new-onset hemodialysis for PCI cases decreased by 50 percent.
The incidence of ARDS and post-operative infection associated with CABG surgery increased during the study period. The increase in the rate of ARDS and post-operative infection complications has an economic toll. Prior research conducted by CDS indicates that ARDS and post-operative infection can add more than $46,000 to hospital costs per admission, which equates to more than $170 million in incremental Medicare costs in FY 2006.
"The decline in the number of revascularization procedures may be attributed to a variety of factors, including changes in medical therapy and PCI technology," says Cardiac Data Solutions founder April Simon, RN, who was one of the researchers. "From a quality perspective, it will be important to monitor patient outcomes for facilities and clinicians to determine if the decline in volumes impacts the ability to gain the necessary proficiency and expertise to maintain the current trend of improved outcomes despite increased patient severity."
The research studied all Medicare beneficiaries undergoing CABG or PCI, with the exception of those with any concomitant valve surgery, in a U.S. hospital between Oct. 1, 2002 and Sept. 30, 2006.
For more information: http://www.cardiacdatasolutions.com.
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