Catheterization
Overall PCI risk-adjusted mortality 2016
This graph shows the in-hospital death rate. Here, a lower number is better. The blue bar shows our number. The gray bar is the average for all U.S. hospitals reporting to the CathPCI Registry*.
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- Age
- Diagnosis on admission and whether the patient is having an ongoing heart attack.
- Presence of cardiogenic shock (inability of the heart function to support body organs).
- Cardiac arrest or cardiac death that occurs outside of the hospital prior to the procedure.
- Heart function and ejection fraction before the procedure.
- The number of diseased blood vessels.
- Emergency of the procedure.
- Kidney function.
- Body mass index.
- Whether the patient has diabetes, heart failure, or chronic lung disease.
The PCI mortality at UK Gill Heart & Vascular Institute was lower than the national average despite the fact that we treat the highest risk patients, more so than most catheterization laboratories around the country. These patients include those with cardiogenic shock or those who had cardiac arrest prior to PCI.
Cardiogenic shock or cardiac arrest prior to PCI
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Discharge medicines
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This shows whether we prescribe the right medicines for our patients when they leave the hospital. A higher number is better. This compares our number to all U.S. hospitals reporting to the CathPCI Registry*.
Appropriateness of PCI in 2016
Presence of plaque or blockage in a coronary artery does not always mean it needs a PCI procedure. Some blockages can be treated effectively with medication alone. It is important that we perform PCI only when appropriate. The American College of Cardiology defines an appropriate PCI procedure. It should be:
- An acceptable and reasonable treatment, and
- Likely to improve the patient’s health or survival.
There are 80 different factors we report to help show that PCI was the right treatment. These include:
- Medical history.
- Medication therapy at home.
- Non-invasive studies: cardiac imaging and stress testing.
- Clinical presentation.
- Cardiac angiography findings and extent of the coronary artery disease.
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The first graph shows procedures for patients with acute coronary syndrome, usually requiring urgent or emergent procedures. The appropriateness at the Gill Heart & Vascular Institute is above 99% for those patients.
The second graph shows procedures to non-acute coronary syndrome patients. These patients usually have chest pain caused by activity and their procedures tend to be planned in advance.
Patient centeredness: radial access
PCI procedures can be performed via the femoral (groin) artery or the radial (wrist) artery. PCI performed via the radial artery is associated with lower risk of bleeding and complications. It is also more convenient as it does not require recovery lying flat on the back. For these reasons, there is a growing trend to use radial access in as many patients and procedures as possible.
Gill Heart & Vascular Institute cardiologists have adopted radial access as the primary access for performing PCI. The graph shows how Gill is ahead of the pace compared to the rest of the catheterization laboratories in the CathPCI Registry*.
* Data Source: The American College of Cardiology’s CathPCI Registry® University of Kentucky Institutional Outcomes Report for years 2012 - 2016. The CathPCI Registry is the only nationwide outcomes-based quality improvement program for hospitals performing percutaneous cardiac intervention procedures. The Registry includes more than 1600 participating hospitals.
Door-to-balloon-time
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This shows how quickly we treat our patients. It is the average time (in minutes) from a patient entering the hospital to getting PCI. A lower time is better. Our goal is to save the heart muscle. When we can open the artery fast, the patient will likely have a better outcome. It should lead to less heart damage, fewer complications, and higher survival rates. This chart compares our time to all U.S. hospitals reporting to the CathPCI Registry*.