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Appropriateness and Outcomes of Percutaneous Coronary Intervention at Top-Ranked and Nonranked Hospitals in the United States.

Publication ,  Journal Article
Sukul, D; Bhatt, DL; Seth, M; Zakroysky, P; Wojdyla, D; Rumsfeld, JS; Wang, T; Rao, SV; Gurm, HS
Published in: JACC Cardiovasc Interv
February 26, 2018

OBJECTIVES: This study sought to compare the appropriate use and outcomes of percutaneous coronary intervention (PCI) between top-ranked and nonranked hospitals. BACKGROUND: The U.S. News & World Report "Best Hospitals" rankings are an influential consumer-directed publication of hospital quality, and are commonly used in promotional campaigns by hospital systems. METHODS: Hospitals in the National Cardiovascular Data Registry CathPCI registry between July 1, 2014, and June 30, 2015, were classified as top-ranked if they were included in the 2015 U.S. News & World Report 50 best "Cardiology and Heart Surgery" hospitals. The remaining were classified as nonranked. We compared in-hospital mortality, post-procedural bleeding, post-procedural acute kidney injury, and the proportion of appropriate PCI procedures between top-ranked and nonranked hospitals. RESULTS: A total of 509,153 PCIs at 654 hospitals were included, of which 55,550 (10.9%) were performed at 44 top-ranked hospitals. After adjusting for patient case mix, PCIs performed at top-ranked hospitals had similar odds of in-hospital mortality (adjusted odds ratio [aOR]: 0.96; 95% confidence interval [CI]: 0.83 to 1.12; p = 0.64), acute kidney injury (aOR: 1.10; 95% CI: 0.98 to 1.22; p = 0.099), and bleeding (aOR: 1.15; 95% CI: 0.99 to 1.31; p = 0.052). Top-ranked hospitals had a slightly lower proportion of appropriate PCI compared with nonranked hospitals (89.2% vs. 92.8%; OR: 0.56; 95% CI: 0.45 to 0.69; p < 0.001). CONCLUSIONS: PCI performed at top-ranked hospitals was not associated with superior outcomes compared with PCI at nonranked hospitals. The inclusion of metrics based on clinical data may be important for hospital quality rankings.

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Published In

JACC Cardiovasc Interv

DOI

EISSN

1876-7605

Publication Date

February 26, 2018

Volume

11

Issue

4

Start / End Page

342 / 350

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Risk Factors
  • Retrospective Studies
  • Registries
  • Quality Indicators, Health Care
  • Process Assessment, Health Care
  • Practice Patterns, Physicians'
  • Practice Guidelines as Topic
  • Percutaneous Coronary Intervention
 

Citation

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Sukul, D., Bhatt, D. L., Seth, M., Zakroysky, P., Wojdyla, D., Rumsfeld, J. S., … Gurm, H. S. (2018). Appropriateness and Outcomes of Percutaneous Coronary Intervention at Top-Ranked and Nonranked Hospitals in the United States. JACC Cardiovasc Interv, 11(4), 342–350. https://doi.org/10.1016/j.jcin.2017.10.042
Sukul, Devraj, Deepak L. Bhatt, Milan Seth, Pearl Zakroysky, Daniel Wojdyla, John S. Rumsfeld, Tracy Wang, Sunil V. Rao, and Hitinder S. Gurm. “Appropriateness and Outcomes of Percutaneous Coronary Intervention at Top-Ranked and Nonranked Hospitals in the United States.JACC Cardiovasc Interv 11, no. 4 (February 26, 2018): 342–50. https://doi.org/10.1016/j.jcin.2017.10.042.
Sukul D, Bhatt DL, Seth M, Zakroysky P, Wojdyla D, Rumsfeld JS, et al. Appropriateness and Outcomes of Percutaneous Coronary Intervention at Top-Ranked and Nonranked Hospitals in the United States. JACC Cardiovasc Interv. 2018 Feb 26;11(4):342–50.
Sukul, Devraj, et al. “Appropriateness and Outcomes of Percutaneous Coronary Intervention at Top-Ranked and Nonranked Hospitals in the United States.JACC Cardiovasc Interv, vol. 11, no. 4, Feb. 2018, pp. 342–50. Pubmed, doi:10.1016/j.jcin.2017.10.042.
Sukul D, Bhatt DL, Seth M, Zakroysky P, Wojdyla D, Rumsfeld JS, Wang T, Rao SV, Gurm HS. Appropriateness and Outcomes of Percutaneous Coronary Intervention at Top-Ranked and Nonranked Hospitals in the United States. JACC Cardiovasc Interv. 2018 Feb 26;11(4):342–350.
Journal cover image

Published In

JACC Cardiovasc Interv

DOI

EISSN

1876-7605

Publication Date

February 26, 2018

Volume

11

Issue

4

Start / End Page

342 / 350

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Risk Factors
  • Retrospective Studies
  • Registries
  • Quality Indicators, Health Care
  • Process Assessment, Health Care
  • Practice Patterns, Physicians'
  • Practice Guidelines as Topic
  • Percutaneous Coronary Intervention