Epidemiology of in-hospital cardiac arrest complicating non-ST-segment elevation myocardial infarction receiving early coronary angiography.

Published on May 1, 2020in American Heart Journal4.749
· DOI :10.1016/J.AHJ.2020.01.016
Saraschandra Vallabhajosyula25
Estimated H-index: 25
(Mayo Clinic),
Saarwaani Vallabhajosyula13
Estimated H-index: 13
(Mayo Clinic)
+ 5 AuthorsJacob C. Jentzer25
Estimated H-index: 25
(Mayo Clinic)
Sources
Abstract
Abstract In the period between 2000 and 2014, 584,704 admissions with non-ST-segment elevation myocardial infarction that received early coronary angiography (day zero) were identified from the National Inpatient Sample. In-hospital cardiac arrest was noted in 4349 (0.8%), of which ~47% were from ventricular arrhythmias and ~90% of occurred within ≤4 days. Non-ST-segment elevation myocardial infarction admissions with in-hospital cardiac arrest had higher in-hospital mortality compared to those without (61% vs. 1.6%) with an unchanged temporal trend of in-hospital cardiac arrest rates (adjusted odds ratio 1.29 [95% confidence interval 0.73–2.28]) in 2014 compared to 2000).
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#1Saraschandra Vallabhajosyula (Mayo Clinic)H-Index: 25
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#2Abhiram Prasad (Mayo Clinic)H-Index: 73
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#1Saraschandra Vallabhajosyula (Mayo Clinic)H-Index: 25
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Abstract Background There are limited data on prolonged invasive mechanical ventilation (IMV) and tracheostomy use in intubated acute myocardial infarction with cardiogenic shock (AMI-CS) patients. Methods Using the National Inpatient Sample, all admissions with AMI-CS requiring IMV between January 1, 2000, and December 31, 2014, were included. Prolonged IMV was defined as IMV use >96 h. Outcomes of interest included temporal trends in use of prolonged IMV and tracheostomy, in-hospital mortality...
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#1Saraschandra Vallabhajosyula (Mayo Clinic)H-Index: 25
#2Shannon M. Dunlay (Mayo Clinic)H-Index: 56
Last. Abhiram Prasad (Mayo Clinic)H-Index: 73
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Abstract Objectives This study sought to evaluate the clinical characteristics and outcomes of Takotusbo cardiomyopathy cardiogenic shock (TC-CS) in comparison to those of acute myocardial infarction cardiogenic shock (AMI-CS) among patients hospitalized in the United States. We additionally sought to compare the incidence of multiorgan failure and use of supportive therapies as well as the trends over time, given the increasing awareness and diagnosis of TC. Background CS is a major complicatio...
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#1Saraschandra Vallabhajosyula (Mayo Clinic)H-Index: 25
#2Shannon M. Dunlay (Mayo Clinic)H-Index: 56
Last. Gregory W. Barsness (Mayo Clinic)H-Index: 41
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Abstract Background There are limited data on acute noncardiac multiorgan failure in cardiogenic shock complicating acute myocardial infarction (AMI-CS). Objectives The authors sought to evaluate the 15-year national trends, resource utilization, and outcomes of single and multiple noncardiac organ failures in AMI-CS. Methods This was a retrospective cohort study of AMI-CS using the National Inpatient Sample database from 2000 to 2014. Previously validated codes for respiratory, renal, hepatic, ...
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#1Sean van Diepen (U of A: University of Alberta)H-Index: 31
#2Dat T. Tran (U of A: University of Alberta)H-Index: 9
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Abstract Background There is substantial variability among hospitals in critical care unit (CCU) utilization for patients admitted with non-ST-Segment Elevation Acute Coronary Syndromes (NSTE ACS). We estimated the potential cost saving if all hospitals adopted low CCU utilization practices for patients with NSTE ACS. Methods National hospital claims data were used to identify all patients with a primary diagnosis of NSTE ACS initially admitted to an acute care hospital between 2007 and 2013. Ho...
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Importance Publicly available data sets hold much potential, but their unique design may require specific analytic approaches. Objective To determine adherence to appropriate research practices for a frequently used large public database, the National Inpatient Sample (NIS) of the Agency for Healthcare Research and Quality (AHRQ). Design, Setting, and Participants In this observational study of the 1082 studies published using the NIS from January 2015 through December 2016, a representative sam...
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Last. Tracy Y. Wang (Duke University)H-Index: 64
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Importance Intensive care unit (ICU) utilization may have important implications for the care and outcomes of patients with non–ST-segment elevation myocardial infarction (NSTEMI). Objectives To examine interhospital variation in ICU utilization in the United States for older adults with hemodynamically stable NSTEMI and outcomes associated with ICU utilization among patients with low, moderate, or high mortality risk. Design, Setting, and Participants This study was a retrospective analysis of ...
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#1Sean van Diepen (U of A: University of Alberta)H-Index: 31
#2Meng Lin (U of A: University of Alberta)H-Index: 10
Last. Justin A. Ezekowitz (U of A: University of Alberta)H-Index: 70
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Background Clinical practice guidelines recommend admitting patients with stable non–ST-segment elevation acute coronary syndrome (NSTE ACS) to telemetry units, yet up to two-thirds of patients are admitted to higher-acuity critical care units (CCUs). The outcomes of patients with stable NSTE ACS initially admitted to a CCU vs a cardiology ward with telemetry have not been described. Methods We used population-based data of 7,869 patients hospitalized with NSTE ACS admitted to hospitals in Alber...
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#1Ezra A. AmsterdamH-Index: 72
#2Nanette K. Wenger (Emory University)H-Index: 94
Last. Susan J. Zieman (NIH: National Institutes of Health)H-Index: 34
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Cited By19
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BACKGROUND Utilization of inpatient palliative care services (PCS) has been infrequently studied in patients with cardiac arrest complicating acute myocardial infarction (AMI-CA). METHODS Adult AMI-CA admissions were identified from the National Inpatient Sample (2000-2017). Outcomes of interest included temporal trends and predictors of PCS use and in-hospital mortality, length of stay, hospitalization costs and discharge disposition in AMI-CA admissions with and without PCS use. Multivariable ...
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#2Sri Harsha Patlolla (Mayo Clinic)H-Index: 9
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Abstract null null Background null Limited studies have evaluated regional disparities in the care of acute myocardial infarction (AMI) patients with cardiac arrest (CA). This study sought to evaluate 18-year national trends, resource utilization, and geographical variation in outcomes in AMI-CA admissions. null null null Methods and Results null Using the National Inpatient Sample (2000-2017), we identified adults with AMI and concomitant CA admitted to the United States census regions of North...
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#1Tanveer Mir (WSU: Wayne State University)H-Index: 6
#2Waqas Qureshi (UMass: University of Massachusetts Amherst)H-Index: 24
Last. Nikolaos Kakouros (UMass: University of Massachusetts Amherst)H-Index: 10
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#2Dhiran Verghese (UCLA: University of California, Los Angeles)H-Index: 4
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AIMS This study aims to evaluate the impact of the combination of cardiogenic shock (CS) and cardiac arrest (CA) complicating non-ST-segment elevation myocardial infarction (NSTEMI). METHODS AND RESULTS Adult (>18 years) NSTEMI admissions using the National Inpatient Sample database (2000 to 2017) were stratified by the presence of CA and/or CS. Outcomes of interest included in-hospital mortality, early coronary angiography, hospitalization costs, and length of stay. Of the 7 302 447 hospitaliza...
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#2Vinayak Kumar (Mayo Clinic)H-Index: 5
Last. Gregory W. Barsness (Mayo Clinic)H-Index: 41
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Background There are limited contemporary data on the influence of primary payer status on the management and outcomes of ST-segment elevation myocardial infarction (STEMI). Objective To assess the influence of insurance status on STEMI outcomes. Methods Adult (>18 years) STEMI admissions were identified using the National Inpatient Sample database (2000–2017). Expected primary payer was classified into Medicare, Medicaid, private, uninsured and others. Outcomes of interest included in-hospital ...
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