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Access route selection for percutaneous coronary intervention among Vietnamese patients: Implications for in-hospital costs and outcomes

Citation

Vu, HTT and Norman, R and Pham, NM and Pham, HM and Nguyen, HTT and Nguyen, QN and Do, LD and Huxley, RR and Lee, CMY and Hoang, TM and Reid, CM, Access route selection for percutaneous coronary intervention among Vietnamese patients: Implications for in-hospital costs and outcomes, The Lancet Regional Health - Western Pacific, 9 pp. 1-7. ISSN 2666-6065 (2021) [Refereed Article]


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Copyright Statement

2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

DOI: doi:10.1016/j.lanwpc.2021.100116

Abstract

Background: Little is known about rates of access site (transradial (TRI) or transfemoral (TFI)) preference for percutaneous coronary intervention (PCI) and in-hospital costs of patients undergoing these procedures in lower-and middle-countries. Here, we report on access site use, in-hospital costs and outcomes of patients undergoing PCI in Vietnam.

Methods: Information from 868 patients were included in the cohort of 1022 patients recruited into the first PCI registry in Vietnam. The total hospital costs and in-hospital outcomes of patients undergoing TRI and TFI were compared. Hospital costs were obtained from the hospital admission system, and major adverse cardiac events, major bleeding events and length of stay were identified through review of medical records.

Findings: TRI was the dominant access site for interventionists (694/868 patients). The TFI group reported more lesions of the left main artery, more previous coronary artery bypass grafts and previous PCI in comparison with the TRI group (all p < 0.05). The TRI group was associated with a lower overall cost of admission (the adjusted difference was -1526.3 USD, 95% confident interval CI (-1996.2; -1056.3), shorter length of hospital stay (-2 days, CI (-2.8; -1.2)) and lower rates of major bleeding post-procedure. Procedural factors such as radial access site, left main disease, PCI ≥2 stents, and PCI ≥ 2 lesions having the most impact on the in-hospital cost of patients undergoing PCI.

Interpretations: Among patients undergoing PCI, TRI was associated with lower costs and favourable clinical outcomes relative to TFI.

Item Details

Item Type:Refereed Article
Keywords:percutaneous coronary intervention, hospital cost, outcomes, Vietnam
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:Pham, NM (Dr Ngoc Minh Pham)
ID Code:146986
Year Published:2021
Deposited By:Menzies Institute for Medical Research
Deposited On:2021-10-07
Last Modified:2021-11-15
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