Volume-Outcome Relation for Hospitals Performing Angioplasty for Acute Myocardial Infarction : Results From the Nationwide Japanese Registry

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概要

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• Background The purpose of this study was to use a contemporary database to examine the relationship between annual hospital volume and the outcomes of percutaneous coronary interventions (PCIs) for acute myocardial infarction (AMI), given the wide spread use of coronary stents. An inverse relation exists between the number of PCIs and short-term outcome, but PCI practice has been changing with the availability of new devices such as stents. Methods and Results Data from the 1997 Japanese nationwide registry were analyzed to determine the relation between the annual hospital volume of PCI procedures for patients with AMI and in-hospital mortality, as well as the need for coronary artery bypass graft (CABG) surgery. A total of 129 hospitals (2,491 patients) were divided into terciles according to the annual volume. Of the procedures, 39% involved coronary stents. Median annual PCI volumes varied across terciles from low=10, middle =33, and high =89. After adjusting for patient characteristics, there was no significant relationship between volume and in-hospital mortality (trend P=0.66) and CABG (trend P=0.35). Among patients who received stents (n=958), there was no significant association between volume and either mortality or CABG. Conclusions Using the contemporary database, there was no significant relationship between hospital volume and in-hospital outcome among AMI patients undergoing PCIs. (Circ J 2004; 68: 887-891)

• 社団法人日本循環器学会の論文
• 2004-09-20

著者

• Tsutsui Hiroyuki

  Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Hokkaido University

• Takeshita Akira

  Department of Cardiology, Saiseikai Futsukaichi Hospital

• TAKESHITA Akira

  Futsukaichi Saiseikai Hospital

• Takeshita A

  Futsukaichi Saiseikai Hospital

• KONO Suminori

  Department of Preventive Medicine, Graduate School of Medical Sciences, Kyushu University

• Kono Suminori

  Departments Of Preventive Medicine Graduate School Of Medical Sciences Kyushu University:japanese Co

• Tsuchihashi Miyuki

  Department Of Cardiovascular Medicine Hokkaido University Graduate School Of Medicine

• Tada Hideo

  Department Of Cardiovascular Medicine Kyushu University Hospital

• Tsutsui Hiroyuki

  Department Of Cardiovascular Medicine

• SHIHARA Miwako

  Department of Cardiovascular Medicine, Cardiovascular Science, Graduate School of Medical Sciences,

• Shihara Miwako

  Departments Of Cardiovascular Medicine Graduate School Of Medical Sciences Kyushu University:japanes

• Shihara Miwako

  Department Of Cardiovascular Medicine Cardiovascular Science Graduate School Of Medical Sciences Kyu

• Takeshita Akira

  Department Of Cardiology Faculty Of Medicine Kyushu University

• Makaya Miyuki

  Department Of Cardiovasucular Medicine Graduate School Of Medical Sciences Kyushu University

• Tada Hideo

  Departments Of Cardiovascular Medicine Graduate School Of Medical Sciences Kyushu University:japanes

• Tada Hideo

  Department Of Cardiology Kyushu University

• Kono Suminori

  Department Of Preventive Medicine Facculty Of Medical Sciences Kyushu University

• Takeshita Akira

  Department Of Cardiovascular Medicine Hokkaido University Graduate School Of Medicine

• Makaya Miyuki

  International Medical Center Of Japan

• Kono Suminori

  Department Of Medicine And Bioregulatory Science Graduate School Of Medical Sciences Kyushu Universi

• Tanaka Atsushi

  Department Of Cardiovascular Medicine Kyushu University

• Tsuchihashi Makaya

  Department Of Clinical Research And Informatics Research Institute International Medical Center Of J

• Tsutsui Hiroyuki

  Departments Of Cardiovascular Medicine Graduate School Of Medical Sciences Kyushu University:japanese Coronary Intervention Study (jcis) Group

• TSUTSUI Hiroyuki

  Department of Cardiology, Iizuka Hospital

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