+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Patterns of in-hospital mortality and bleeding complications following PCI for very elderly patients: insights from the Dartmouth Dynamic Registry



Patterns of in-hospital mortality and bleeding complications following PCI for very elderly patients: insights from the Dartmouth Dynamic Registry



Journal of Geriatric Cardiology 15(2): 131-136



Very elderly patients (age ≥ 85 years) are a rapidly increasing segment of the population. As a group, they experience high rates of in-hospital mortality and bleeding complications following percutaneous coronary intervention (PCI). However, the relationship between bleeding and mortality in the very elderly is unknown. Retrospective review was performed on 17,378 consecutive PCI procedures from 2000 to 2015 at Dartmouth-Hitchcock Medical Center. Incidence of bleeding during the index PCI admission (bleeding requiring transfusion, access site hematoma > 5 cm, pseudoaneurysm, and retroperitoneal bleed) and in-hospital mortality were reported for four age groups (< 65 years, 65-74 years, 75-84 years, and ≥ 85 years). The mortality of patients who suffered bleeding complications and those who did not was calculated and multivariate analysis was performed for in-hospital mortality. Lastly, known predictors of bleeding were compared between patients age < 85 years and age ≥ 85 years. Of 17,378 patients studied, 1019 (5.9%) experienced bleeding and 369 (2.1%) died in-hospital following PCI. Incidence of bleeding and in-hospital mortality increased monotonically with increasing age (mortality: 0.94%, 2.27%, 4.24% and 4.58%; bleeding: 3.96%, 6.62%, 10.68% and 13.99% for ages < 65, 65-74, 75-84 and ≥ 85 years, respectively). On multivariate analysis, bleeding was associated with increased mortality for all age groups except patients age ≥ 85 years [odds ratio (95% CI): age < 65 years, 3.65 (1.99-6.74); age 65-74 years, 2.83 (1.62-4.94); age 75-84 years, 3.86 (2.56-5.82), age ≥ 85 years: 1.39 (0.49-3.95)]. Bleeding and mortality following PCI increase with increasing age. For the very elderly, despite high rates of bleeding, bleeding is no longer predictive of in-hospital mortality following PCI.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 065392796

Download citation: RISBibTeXText

PMID: 29662506

DOI: 10.11909/j.issn.1671-5411.2018.02.006


Related references

Transient and persistent postprocedural renal dysfunction as predictors of 8 year mortality after cardiac catheterization insights from the dartmouth dynamic registry. 2007

Global Geriatric Assessment and In-Hospital Bleeding Risk in Elderly Patients with Acute Coronary Syndromes: Insights from the LONGEVO-SCA Registry. Thrombosis and Haemostasis 118(3): 581-590, 2018

Treating patients with acute coronary syndromes with aggressive anti-platelet agents in the grace registry No observed decrease in in-hospital mortality but increased bleeding complications. European Heart Journal 24(Abstract Supplement): 547, August-September, 2003

The impact of hematocrit drop on long-term survival after cardiac catheterization: insights from the Dartmouth Dynamic Registry. Catheterization and Cardiovascular Interventions 75(3): 378-386, 2010

The Impact of Bleeding Avoidance Strategies on Hospital-Level Variation in Bleeding Rates Following Percutaneous Coronary Intervention: Insights From the National Cardiovascular Data Registry CathPCI Registry. Jacc. Cardiovascular Interventions 9(8): 771-779, 2017

Transient and persistent renal dysfunction are predictors of survival after percutaneous coronary intervention: insights from the Dartmouth Dynamic Registry. Catheterization and Cardiovascular Interventions 72(3): 347-354, 2008

Prediction of Post-Discharge Bleeding in Elderly Patients with Acute Coronary Syndromes: Insights from the BleeMACS Registry. Thrombosis and Haemostasis 118(5): 929-938, 2018

In-hospital major bleeding predicts mortality in patients with pulmonary embolism: an analysis of ZATPOL Registry data. International Journal of Cardiology 168(4): 3543-3549, 2014

Anemia predicts thromboembolic events, bleeding complications and mortality in patients with atrial fibrillation: insights from the RE-LY trial. Journal of Thrombosis and Haemostasis 13(5): 699-707, 2016

Risk Factors and Complications Contributing to Mortality in Elderly Patients with Fall-Induced Femoral Fracture: A Cross-sectional Analysis Based on Trauma Registry Data of 2,407 patients. International Journal of Surgery 2019, 2019

Predictors of in-hospital mortality in a cohort of elderly Egyptian patients with acute upper gastrointestinal bleeding. Medicine 97(16): E0403, 2018

Comparison of bleeding complications and one-year survival of low molecular weight heparin versus unfractioned heparin for acute myocardial infarction in elderly patients. The FAST-MI registry. International Journal of Cardiology 166(1): 106-110, 2014

Predictors of in-hospital mortality and complications in very elderly patients undergoing emergency surgery. World Journal of Emergency Surgery 9: 43, 2014

In-hospital bleeding events in acute coronary syndrome patients undergoing percutaneous coronary intervention in the era of novel P2Y12 inhibitors: insights from the GReek AntiPlatelet rEgistry-GRAPE. International Journal of Cardiology 174(1): 160-162, 2015

Sleep patterns and mortality among elderly patients in a geriatric hospital. Gerontology 46(6): 318-322, 2000