Relation between hospital intra-aortic balloon counterpulsation volume and mortality in acute myocardial infarction complicated by cardiogenic shock

Increasing evidence suggests an inverse relationship between outcome and the total number of invasive cardiac procedures performed at a given hospital. The purpose of the present study was to determine if a similar relationship exists between the number of intra-aortic balloon counterpulsation (IABP...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2003-08, Vol.108 (8), p.951-957
Main Authors: Chen, Edmond W, Canto, John G, Parsons, Lori S, Peterson, Eric D, Littrell, Katherine A, Every, Nathan R, Gibson, C Michael, Hochman, Judith S, Ohman, E Magnus, Cheeks, Morris, Barron, Hal V
Format: Article
Language:English
Subjects:
Acute Disease
Aged
Cohort Studies
Comorbidity
Female
Hospital Mortality
Humans
Intra-Aortic Balloon Pumping - utilization
Male
Myocardial Infarction - mortality
Myocardial Infarction - physiopathology
Outcome Assessment (Health Care) - statistics & numerical data
Registries - statistics & numerical data
Retrospective Studies
Shock, Cardiogenic - mortality
Shock, Cardiogenic - physiopathology
Shock, Cardiogenic - therapy
United States - epidemiology
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Summary:Increasing evidence suggests an inverse relationship between outcome and the total number of invasive cardiac procedures performed at a given hospital. The purpose of the present study was to determine if a similar relationship exists between the number of intra-aortic balloon counterpulsation (IABP) procedures performed at a given hospital per year and the in-hospital mortality rate of patients with acute myocardial infarction complicated by cardiogenic shock. We analyzed data of 12 730 patients at 750 hospitals enrolled in the National Registry of Myocardial Infarction 2 from 1994 to 1998. The hospitals were divided into tertiles (low-, intermediate-, and high-IABP volume hospitals) according to the number of IABPs performed at the given hospital per year. The median number of IABPs performed per hospital per year was 3.4, 12.7, and 37.4 IABPs at low-, intermediate-, and high-volume hospitals, respectively. Of those patients who underwent IABP, there were only minor differences in baseline patient characteristics between the 3 groups. Crude mortality rate decreased with increasing IABP volume: 65.4%, lowest volume tertile; 54.1%, intermediate volume tertile; and 50.6%, highest volume tertile (P for trend
ISSN:0009-7322
1524-4539
DOI:10.1161/01.cir.0000085068.59734.e4