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Understanding operator stent choice in the catheterization laboratory using a pre-procedure survey: Opportunities for quality improvement.

Publication ,  Journal Article
Chung, MJ; Hansen, JD; Schulteis, RD; Boggan, JC; Jones, WS; Povsic, TJ; Roberts, S; Krucoff, MW; Rao, SV
Published in: Cardiovasc Revasc Med
December 2017

OBJECTIVES: We sought to characterize how the perceived risk of early dual antiplatelet therapy (DAPT) discontinuation is incorporated into operator decision-making regarding stent choice, using a simple pre-procedure survey screening for clinical variables that may lead to early DAPT discontinuation. BACKGROUND: Understanding which factors influence operator decision-making regarding stent choice during percutaneous coronary intervention (PCI) could help identify areas for quality improvement. METHODS: We retrospectively identified 1202 patients who underwent PCI from July 2008 to January 2013 at the Durham Veterans Affairs Medical Center. We excluded patients without a complete pre-procedure survey within 14days of PCI, repeat procedures on the same patient and those who received both drug-eluting stents (DES) and bare-metal stents (BMS) or no stent during PCI, leaving 864 patients. The primary outcome was the independent association of "yes" responses to survey items with the odds of DES use during PCI. RESULTS: Of 864 patients, 661 received DES and 203 received BMS. A "yes" response to "planned major surgery or dental work in the next year" (OR 0.20, 95% CI 0.11-0.36, p<0.001), "recent bleeding event or bleeding diathesis" (OR 0.31, 95% CI 0.14-0.68, p=0.003) or "currently taking Coumadin" (OR 0.39, 95% CI 0.19-0.78, p=0.007) was independently associated with lower odds of DES use. CONCLUSIONS: Responses to 3 items on a simple pre-procedure survey screening for clinical variables that may lead to early DAPT discontinuation were independently associated with stent type used during PCI, suggesting the importance of these factors in an operator's stent choice.

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Published In

Cardiovasc Revasc Med

DOI

EISSN

1878-0938

Publication Date

December 2017

Volume

18

Issue

8

Start / End Page

588 / 591

Location

United States

Related Subject Headings

  • Warfarin
  • United States Department of Veterans Affairs
  • United States
  • Treatment Outcome
  • Time Factors
  • Surgical Procedures, Operative
  • Stents
  • Risk Factors
  • Retrospective Studies
  • Prosthesis Design
 

Citation

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ICMJE
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Chung, M. J., Hansen, J. D., Schulteis, R. D., Boggan, J. C., Jones, W. S., Povsic, T. J., … Rao, S. V. (2017). Understanding operator stent choice in the catheterization laboratory using a pre-procedure survey: Opportunities for quality improvement. Cardiovasc Revasc Med, 18(8), 588–591. https://doi.org/10.1016/j.carrev.2017.05.004
Chung, Matthew J., Jonathan D. Hansen, Ryan D. Schulteis, Joel C. Boggan, W Schuyler Jones, Thomas J. Povsic, Susan Roberts, Mitchell W. Krucoff, and Sunil V. Rao. “Understanding operator stent choice in the catheterization laboratory using a pre-procedure survey: Opportunities for quality improvement.Cardiovasc Revasc Med 18, no. 8 (December 2017): 588–91. https://doi.org/10.1016/j.carrev.2017.05.004.
Chung MJ, Hansen JD, Schulteis RD, Boggan JC, Jones WS, Povsic TJ, et al. Understanding operator stent choice in the catheterization laboratory using a pre-procedure survey: Opportunities for quality improvement. Cardiovasc Revasc Med. 2017 Dec;18(8):588–91.
Chung, Matthew J., et al. “Understanding operator stent choice in the catheterization laboratory using a pre-procedure survey: Opportunities for quality improvement.Cardiovasc Revasc Med, vol. 18, no. 8, Dec. 2017, pp. 588–91. Pubmed, doi:10.1016/j.carrev.2017.05.004.
Chung MJ, Hansen JD, Schulteis RD, Boggan JC, Jones WS, Povsic TJ, Roberts S, Krucoff MW, Rao SV. Understanding operator stent choice in the catheterization laboratory using a pre-procedure survey: Opportunities for quality improvement. Cardiovasc Revasc Med. 2017 Dec;18(8):588–591.
Journal cover image

Published In

Cardiovasc Revasc Med

DOI

EISSN

1878-0938

Publication Date

December 2017

Volume

18

Issue

8

Start / End Page

588 / 591

Location

United States

Related Subject Headings

  • Warfarin
  • United States Department of Veterans Affairs
  • United States
  • Treatment Outcome
  • Time Factors
  • Surgical Procedures, Operative
  • Stents
  • Risk Factors
  • Retrospective Studies
  • Prosthesis Design