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Clinical and Economic Burden of Percutaneous Coronary Intervention in Hospitalized Young Adults in the United States, 2004-2018.
Minhas AMK, Awan MU, Raza M, Virani SS, Sharma G, Blankstein R, Blaha MJ, Al-Kindi SG, Kaluksi E, Nasir K, Khan SU. Clinical and Economic Burden of Percutaneous Coronary Intervention in Hospitalized Young Adults in the United States, 2004-2018. Current problems in cardiology. 2021 Nov 26; 101070.
The clinical and economic burden of percutaneous coronary intervention (PCI) in young adults (18-45 years) is understudied. We used the National Inpatient Sample database between 2004 and 2018 to study trends in PCI volume, in-hospital mortality, length of stay (LOS), and health care expenditure among adults aged 18 to 44 years who underwent PCI. The data were weighted to explore national estimates of the entire US hospitalized population. We identified 558,611 PCI cases, equivalent to 31.4 per 1,000,000 person-years; 25.4% were women, and 69.5% were White adults. Overall, annual PCI volume significantly decreased from 41.6 per 100,000 in 2004 to 21.9 per 100,000 in 2018, mainly due to 83% volume reduction in non-myocardial infarction (MI) cases. The prevalence of cardiometabolic comorbidities, smoking, and drug abuse increased. Overall, in-hospital mortality was 0.87%; women had higher mortality than men (1.12% vs 0.78%; P = 0.01). The crude and risk-adjusted in-hospital mortality significantly increased between 2004 and 2018. Women, STEMI, NSTEMI, drug abuse, heart failure, peripheral vascular disease, and renal failure were associated with higher odds of in-hospital mortality. Inflation-adjusted cost significantly increased over time ($21,567 to $24,173). We noted reduction in PCI volumes but increasing mortality and clinical comorbidities among young patients undergoing PCI. Demographic disparities existed with women having higher in-hospital mortality than men.