1. Comparison of Inhospital Outcomes and Hospitalization Costs of Peripheral Angioplasty and Endovascular Stenting.
- Author
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Panaich SS, Arora S, Patel N, Patel NJ, Lahewala S, Solanki S, Manvar S, Savani C, Jhamnani S, Singh V, Patel SV, Thakkar B, Patel A, Deshmukh A, Chothani A, Bhatt P, Savani GT, Patel J, Mavani K, Bhimani R, Tripathi B, Mohamad T, Remetz MS, Curtis JP, Attaran RR, Grines C, Mena CI, Cleman M, Forrest JK, and Badheka AO
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Angioplasty adverse effects, Angioplasty economics, Cohort Studies, Databases, Factual, Female, Hospital Mortality, Hospitalization statistics & numerical data, Humans, Male, Middle Aged, Peripheral Arterial Disease economics, Peripheral Arterial Disease mortality, Propensity Score, Stents adverse effects, Stents economics, Treatment Outcome, United States epidemiology, Young Adult, Angioplasty statistics & numerical data, Health Care Costs, Hospitalization economics, Peripheral Arterial Disease surgery, Stents statistics & numerical data
- Abstract
The comparative data for angioplasty and stenting for treatment of peripheral arterial disease are largely limited to technical factors such as patency rates with sparse data on clinical outcomes like mortality, postprocedural complications, and amputation. The study cohort was derived from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database from 2006 to 2011. Peripheral endovascular interventions were identified using appropriate International Classification of Diseases, Ninth Revision (ICD-9) Diagnostic and procedural codes. Two-level hierarchical multivariate mixed models were created. The primary outcome includes inhospital mortality, and secondary outcome was a composite of inhospital mortality and postprocedural complications. Amputation was a separate outcome. Hospitalization costs were also assessed. Endovascular stenting (odds ratio, 95% confidence interval, p value) was independently predictive of lower composite end point of inhospital mortality and postprocedural complications compared with angioplasty alone (0.96, 0.91 to 0.99, 0.025) and lower amputation rates (0.56, 0.53 to 0.60, <0.001) with no significant difference in terms of inhospital mortality alone. Multivariate analysis also revealed stenting to be predictive of higher hospitalization costs ($1,516, 95% confidence interval 1,082 to 1,950, p <0.001) compared with angioplasty. In conclusion, endovascular stenting is associated with a lower rate of postprocedural complications, lower amputation rates, and only minimal increase in hospitalization costs compared with angioplasty alone., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2015
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