Table 1:
Hospital and patient characteristics by operator volume
| Overall (n = 723,644 PCIs; 8,936 operators) |
High (> 100 PCIs/year) (n = 437,977 PCIs; 2,553 operators) | Intermediate (50–100 PCIs/year) (n = 210,946 PCIs; 2,878 operators) | Low (< 50 PCIs/year) (n = 74,721 PCIs; 3,505 operators) | P value | |
|---|---|---|---|---|---|
| Hospital characteristics | |||||
| Hospital region | < 0.0001 | ||||
| Northeast | 104,044 (14.4%) | 68,760 (15.7%) | 27,577 (13.1%) | 7,707 (10.3%) | |
| Midwest | 204,514 (28.3%) | 133,946 (30.6%) | 56,238 (26.7%) | 14,330 (19.2%) | |
| South | 316,948 (43.8%) | 192,835 (44.0%) | 89,851 (42.6%) | 34,262 (45.9%) | |
| West | 98,114 (13.6%) | 42,436 (9.7%) | 37,280 (17.7%) | 18,398 (24.6%) | |
| Urban location | 395,016 (54.6%) | 249,338 (56.9%) | 106,636 (50.6%) | 39,042 (52.3%) | < 0.0001 |
| No. of beds | 393 (261, 576) | 404 (270, 587) | 364 (250, 540) | 366 (250, 569) | < 0.0001 |
| Annual PCI volume | 663 (406, 1083) | 770 (490, 1231) | 541 (340, 859) | 484 (268, 847) | < 0.0001 |
| Teaching hospital* | 333,131 (46.0%) | 220,510 (50.4%) | 85,423 (40.5%) | 27,207 (36.4%) | < 0.0001 |
| Private/community hospital | 641,075 (88.6%) | 386,876 (88.3%) | 187,723 (89.0%) | 66,476 (89.0%) | < 0.0001 |
| Patient characteristics | |||||
| Age | 74 (69, 80) | 74 (69, 80) | 74 (69, 80) | 74 (69, 79) | 0.0002 |
| Male | 448,322 (62.0%) | 270,732 (61.8%) | 130,939 (62.1%) | 46,651 (62.4%) | 0.002 |
| White | 662,486 (91.6%) | 404,367 (92.3%) | 192,200 (91.1%) | 65,919 (88.2%) | < 0.0001 |
| Admit source | < 0.0001 | ||||
| Emergency dept | 251,165 (34.7%) | 142,341 (32.5%) | 80,119 (38.0%) | 28,705 (38.4%) | |
| Transfer in | 129,335 (17.9%) | 85,911 (19.6%) | 33,633 (15,9%) | 9,791 (13.1%) | |
| Other | 342,418 (47.3%) | 209,294 (478%) | 96,978 (46.0%) | 36,146 (48.4%) | |
| BMI | 28 (25, 32) | 28 (25, 32) | 28 (25, 32) | 28 (25, 32) | < 0.0001 |
| GFR | 67 (52, 85) | 67 (52, 85) | 68 (52, 85) | 68 (53, 86) | < 0.0001 |
| Prior MI | 196,693 (27.2%) | 121,856 (27.8%) | 55,706 (26.4%) | 19,131 (25.6%) | < 0.0001 |
| Prior CHF | 111,603 (15.4%) | 70,498 (16.1%) | 30,937 (14.7%) | 10,168 (13.6%) | < 0.0001 |
| HF within 2 weeks | 97,340 (13.5%) | 60,451 (13.8%) | 27,913 (13.2%) | 8,976 (12.0%) | < 0.0001 |
| LV systolic dysfunction | 90,579 (12.5%) | 56,565 (12.9%) | 25,884 (12.3%) | 8,130 (10.9%) | < 0.0001 |
| Cardiogenic shock within 24 hours | 21,785 (3.0%) | 12,321 (2.8%) | 6,976 (3.3%) | 2,488 (3.3%) | < 0.0001 |
| Cardiac arrest within 24 hours | 12,573 (1.7%) | 7,093 (1.6%) | 4,020 (1.9%) | 1,460 (2.0%) | < 0.0001 |
| Diabetes | 269,926 (37.3%) | 165,231 (37.7%) | 77,520 (36.8%) | 27,175 (36.4%) | < 0.0001 |
| Cerebrovascular disease | 122,238 (16.9%) | 76,600 (17.5%) | 34,323 (16.3%) | 11,315 (15.1%) | < 0.0001 |
| Peripheral vascular disease | 115,744 (16.0%) | 72,681 (16.6%) | 32,577 (15.4%) | 10,486 (14.0%) | < 0.0001 |
| Hypertension | 626,220 (86.5%) | 381,203 (87.0%) | 171,054 (85.8%) | 63,963 (85.6%) | < 0.0001 |
| Chronic lung disease | 133,221 (18.4%) | 83,611 (19.1%) | 37,596 (17.8%) | 12,014 (16.1%) | < 0.0001 |
| Current/recent smoker | 100,217 (13.9%) | 61,172 (14.0%) | 29,156 (13.8%) | 9,889 (13.2%) | 0.05 |
| Dyslipidemia | 583,235 (80.6%) | 356,374 (81.4%) | 168,008 (79.7%) | 58,853 (78.8%) | < 0.0001 |
| Prior PCI | 246,607 (34.1%) | 152,378 (34.8%) | 69,455 (32.9%) | 24,774 (33.2%) | < 0.0001 |
| Prior CABG | 163,621 (22.6%) | 102,379 (23.4%) | 45,590 (21.6%) | 15,652 (21.0%) | < 0.0001 |
| Admission symptoms | < 0.0001 | ||||
| No symptoms | 55,855 (7.7%) | 32,540 (7.4%) | 16,674 (7.9%) | 6,641 (8.9%) | |
| Atypical chest pain | 23,541 (3.3%) | 14,395 (3.3%) | 6,747 (3.2%) | 2,399 (3.2%) | |
| Stable angina | 133,145 (16.9%) | 73,951 (16.9%) | 34,787 (16.5%) | 13,407 (17.9%) | |
| Unstable angina | 280,997 (38.8%) | 175,768 (40.1%) | 78,456 (37.2%) | 26,773 (35.8%) | |
| NSTEMI | 146,333 (20.2%) | 89,260 (20.4%) | 43,130 (20.5%) | 13,943 (18.7%) | |
| STEMI | 94,616 (13.1%) | 51,988 (11.9%) | 31,099 (14.7%) | 11,529 (15.4%) | |
| Appropriate PCI | 576,831 (79.7%) | 350,648 (80.1%) | 158,186 (79.7%) | 57,997 (77.6%) | < 0.0001 |
| PCI status | < 0.0001 | ||||
| Elective | 321,495 (44.4%) | 195,377 (44.6%) | 91,413 (43.3%) | 34,705 (46.5%) | |
| Urgent | 294,611 (40.7%) | 183,490 (41.9%) | 84,228 (39.9%) | 26,893 (36.0%) | |
| Emergency | 104,729 (14.5%) | 57,576 (13.2%) | 34,369 (16.3%) | 12,784 (17.1%) | |
| Salvage | 2,517 (0.4%) | 1,360 (0.3%) | 853 (0.4%) | 304 (0.4%) | |
| Discharge Medications | |||||
| Aspirin | 671,417 (96.1%) | 408,429 (96.5%) | 194,610 (95.8%) | 68,378 (95.1%) | < 0.0001 |
| P2Y12 inhibitor | 674,862 (95.7%) | 410,615 (96.0%) | 195,493 (95.3%) | 68,754 (94.8%) | < 0.0001 |
| Statin | 609,710 (88.4%) | 369,974 (88.6%) | 177,470 (88.4%) | 62,266 (87.3%) | < 0.0001 |
| Beta blocker | 568,723 (83.0%) | 347,100 (83.7%) | 164,628 (82.5%) | 56,995 (80.7%) | < 0.0001 |
*
, residency/fellowship program; BMI, body mass index; GFR, glomerular filtration rate, calculated by the Modification of Diet in Renal Disease equation; MI, myocardial infarction; CHF, congestive heart failure; HF, heart failure; LV, left ventricular; PCI, percutaneous coronary intervention; CABG, coronary artery bypass graft surgery; NSTEMI, non-ST segment elevation myocardial infarction; STEMI, ST segment elevation myocardial infarction.