Cause and preventability of in-hospital mortality after PCI: A statewide root-cause analysis of 1,163 deaths
Recommended Citation
Moroni F, Seth M, Changezi HU, Karve M, Arora DS, Sharma M, Pielsticker E, Berman AD, Lee D, Qureshi MI, Azzalini L, Sukul D, and Gurm HS. Cause and preventability of in-hospital mortality after PCI: A statewide root-cause analysis of 1,163 deaths. PLoS One 2024; 19(3):e0297596.
Document Type
Article
Publication Date
1-1-2024
Publication Title
PLoS One
Abstract
BACKGROUND: Mortality is the most devastating complication of percutaneous coronary interventions (PCI). Identifying the most common causes and mechanisms of death after PCI in contemporary practice is an important step in further reducing periprocedural mortality.
OBJECTIVES: To systematically analyze the cause and circumstances of in-hospital mortality in a large, multi-center, statewide cohort.
METHODS: In-hospital deaths after PCI occurring at 39 hospitals included in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) between 2012 and 2014 were retrospectively reviewed using validated methods. A priori PCI-related mortality risk was estimated using the validated BMC2 model.
RESULTS: A total of 1,163 deaths after PCI were included in the study. Mean age was 71±13 years, and 507 (44%) were women. Left ventricular failure was the most common cause of death (52% of cases). The circumstance of death was most commonly related to prior acute cardiovascular condition (61% of cases). Procedural complications were considered contributing to mortality in 235 (20%) cases. Death was rated as not preventable or slightly preventable in 1,045 (89.9%) cases. The majority of the deaths occurred in intermediate or high-risk patients, but 328 (28.2%) deaths occurred in low-risk patients (<5% predicted risk of mortality). PCI was considered rarely appropriate in 30% of preventable deaths.
CONCLUSIONS: In-hospital mortality after PCI is rare, and primarily related to pre-existing critical acute cardiovascular condition. However, approximately 10% of deaths were preventable. Further research is needed to characterize preventable deaths, in order to develop strategies to improve procedural safety.
Medical Subject Headings
Humans; Female; Middle Aged; Aged; Aged, 80 and over; Male; Percutaneous Coronary Intervention; Hospital Mortality; Retrospective Studies; Cardiovascular Diseases; Michigan; Treatment Outcome; Risk Factors
PubMed ID
38536790
Volume
19
Issue
3
First Page
0297596
Last Page
0297596
