In-hospital outcomes after elective and non-elective percutaneous coronary interventions in hospitals with and without on-site cardiac surgery backup

  • Ulrich Tebbe
  • Matthias Hochadel
  • Peter Bramlage
  • Sebastian Kerber
  • Rainer Hambrecht
  • Eberhard Grube
  • Karl E. Hauptmann
  • Martin Gottwik
  • Albrecht Elsässer
  • Hans-Georg Glunz
  • Tassilo Bonzel
  • Jörg Carlsson
  • Uwe Zeymer
  • Ralf Zahn
  • Jochen Senges
Original Paper

Abstract

Background

Guidelines recommend on-site surgery backup (SB) when elective percutaneous coronary intervention (PCI) is performed. The evidence for this recommendation is however weak.

Objectives

The objective of the present study was to compare clinical outcomes in patients undergoing PCI in hospitals with SB or without surgery backup (non-SB).

Methods

Prospective German PCI registry in 36 hospitals throughout Germany. Consecutive procedures were collected and analyzed centrally.

Results

In 2006, a total of 23,148 patients were included; 12,465 patients (53.8%) in 11 hospitals with SB and 10,683 patients (46.2%) in 25 hospitals without on-site cardiac SB. Both patient groups were well-balanced with regard to age and gender. SB hospitals had more patients with ACS (OR 1.29; 95%CI 1.23–1.36) and less patients with stable angina (OR 0.78; 95%CI 0.74–0.82) than non-SB hospitals. There was no indication of a clinically relevant differential outcome for in-hospital death, MACE, non-fatal MI, non-fatal stroke/TIA, or emergency CABG between SB and non-SB hospitals for neither patients with ACS nor stable angina except for emergency CABG in ACS patients (more frequent in SB hospitals, OR 2.29; 95%CI 1.02–5.13).

Conclusions

There was no evidence of an excess risk associated with PCI-procedures performed in non-SB hospitals.

Keywords

PCI Surgery backup Outcome MACE Mortality 

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Ulrich Tebbe
    • 1
  • Matthias Hochadel
    • 2
  • Peter Bramlage
    • 3
  • Sebastian Kerber
    • 4
  • Rainer Hambrecht
    • 5
  • Eberhard Grube
    • 6
  • Karl E. Hauptmann
    • 7
  • Martin Gottwik
    • 8
  • Albrecht Elsässer
    • 9
  • Hans-Georg Glunz
    • 10
  • Tassilo Bonzel
    • 11
  • Jörg Carlsson
    • 12
  • Uwe Zeymer
    • 2
  • Ralf Zahn
    • 13
  • Jochen Senges
    • 2
  1. 1.Klinikum Lippe GmbHFachbereich Herz-KreislaufDetmoldGermany
  2. 2.Stiftung Institut für Herzinfarktforschung Ludwigshafen an der Universität HeidelbergLudwigshafenGermany
  3. 3.Institut für kardiovaskuläre Pharmakologie und EpidemiologieMahlowGermany
  4. 4.Herz- und Gefäßklinik GmbHBad NeustadtGermany
  5. 5.Krankenhaus Links der WeserBremenGermany
  6. 6.Helios Klinikum SiegburgSiegburgGermany
  7. 7.Krankenhaus der Barmherzigen BrüderTrierGermany
  8. 8.Klinikum Nürnberg SüdNürnbergGermany
  9. 9.Städt. Kliniken OldenburgOldenburgGermany
  10. 10.Westpfalz-Klinikum GmbH, Standort I KaiserlauternKaiserlauternGermany
  11. 11.Klinikum FuldaFuldaGermany
  12. 12.Länssjukhuset i Kalmar, LasarettsvägenKalmarSweden
  13. 13.Herzzentrum LudwigshafenKlinikum der Stadt Ludwigshafen gGmbHLudwigshafenGermany

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