Citations 2
Impact of Glycoprotein IIb/IIIa Inhibitors Use on Outcomes After Lower Extremity Endovascular Interventions From Nationwide Inpatient Sample (2006–2011)
Arora, Shilpkumar , Panaich, Sidakpal , Patel, Nilay , Patel, Nileshkumar , Lahewala, Sopan , Thakkar, Badal, Savani, Chirag, Jhamnani, Sunny , Singh, Vikas , Patel, Nish , Patel, Samir , Sonani, Rajesh, Patel, Achint , Deshmukh, Abhishek , Chothani, Ankit , Bhatt, Parth , Mohamad, Tamam , Remetz, Michael S., Curtis, Jeptha P. , Attaran, Ramak R., Mena, Carlos, Schreiber, Theodore , Cleman, Michael , Forrest, John K. , Badheka, Apurva O., Tripathi, Byomesh , Patel, Jay N. , Grines, Cindy L. , Panaich, Sidakpal S
Catheterization and Cardiovascular Interventions | February 25, 2016 | Volume: 88 | Issue: 4 | Pages: 605-616
ObjectiveThe aim of our study was to study the impact of glycoprotein IIb/IIIa inhibitors (GPI) on in‐hospital outcomes.BackgroundThere is paucity of data regarding the impact of GPI on the outcomes following peripheral endovascular interventions.MethodsThe study cohort was derived from Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) database between the years 2006 and 2011. Peripheral endovascular interventions and GPI utilization were identified using appropriate ICD‐9 Diagnostic and procedural codes. Two‐level hierarchical multivariate mixed models were created. The study outcomes were: primary (in‐hospital mortality and amputation studied separately) and secondary (composite of in‐hospital mortality and postprocedural complications). Hospitalization costs were also assessed.ResultsGPI utilization (OR, 95% CI, P‐value) was independently predictive of lower amputation rates (0.36, 0.27–0.49, <0.001). There was no significant difference in terms of in‐hospital mortality (0.59, 0.31–1.14, P 0.117), although GPI use predicted worse secondary outcomes (1.23, 1.03–1.47, 0.023). Following propensity matching, the amputation rate was lower (3.2% vs. 8%, P < 0.001), while hospitalization costs were higher in the cohort that received GPI ($21,091 ± 404 vs. 19,407 ± 133, P < 0.001).ConclusionsMultivariate analysis revealed GPI use in peripheral endovascular interventions to be suggestive of an increase in composite end‐point of in‐hospital mortality and postprocedural complications, no impact on in‐hospital mortality alone, significantly lower rate of amputation, and increase in hospitalization costs. © 2016 Wiley Periodicals, Inc.
Intravascular Ultrasound in Lower Extremity Peripheral Vascular Interventions
Panaich, Sidakpal , Arora, Shilpkumar , Patel, Nilay , Patel, Nileshkumar , Savani, Chirag, Patel, Achint , Thakkar, Badal, Singh, Vikas , Patel, Nish , Agnihotri, Kanishk, Bhatt, Parth , Deshmukh, Abhishek , Gupta, Vishal , Attaran, Ramak R., Mena, Carlos, Cleman, Michael , Forrest, John K. , Badheka, Apurva O., Patel, Samir , Grines, Cindy L. , Panaich, Sidakpal S
Journal of Endovascular Therapy | December 26, 2015 | Volume: 23 | Issue: 1 | Pages: 65-75
Purpose: To examine the impact of intravascular ultrasound (IVUS) utilization during lower limb endovascular interventions as regards postprocedural complications and amputation. Methods: The study cohort was derived from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database between the years 2006 and 2011. Peripheral endovascular interventions were identified using appropriate ICD-9 procedure codes. Two-level hierarchical multivariate mixed models were created. The co-primary outcomes were in-hospital mortality and amputation; the secondary outcome was postprocedural complications. Model results are given as the odds ratio (OR) and 95% confidence interval (CI). Hospitalization costs were also assessed. Results: Overall, among the 92,714 patients extracted from the database during the observation period, IVUS was used in 1299 (1.4%) patients. IVUS utilization during lower extremity peripheral vascular procedures was independently predictive of a lower rate of postprocedural complications (OR 0.80, 95% CI 0.66 to 0.99, p=0.037) as well as lower amputation rates (OR 0.59, 95% CI 0.45 to 0.77, p<0.001) without any significant impact on in-hospital mortality. Multivariate analysis also revealed IVUS utilization to be predictive of a nonsignificant increase in hospitalization costs ($1333, 95% CI −$167 to +$2833, p=0.082). Conclusion: IVUS use during lower limb endovascular interventions is predictive of lower postprocedural complication and amputation rates with a nonsignificant increase in hospitalization costs.