PCI outcomes similar at top-ranked, unranked hospitals

Hospitals ranked in the top 50 for cardiology and heart surgery by U.S. News and World Report appear no better at performing PCI than unranked hospitals, according to an analysis of more than 500,000 procedures performed at 654 hospitals.

After adjusting for patient case mix, researchers found similar rates of in-hospital mortality, acute kidney injury and post-procedural bleeding in ranked and unranked hospitals. Top-ranked hospitals had a slightly lower proportion of appropriate PCI procedures (89.2 percent versus 92.8 percent) when compared to non-ranked hospitals.

Lead study author Devraj Sukul, MD, a cardiology fellow at the University of Michigan, and colleagues presented these findings at the American Heart Association’s scientific sessions and published them online simultaneously in JACC: Cardiovascular Interventions.

“Previous studies have found that top-ranked hospitals generally performed better than non-ranked hospitals for many cardiovascular conditions,” Sukul said in a press release. “However, due to significant quality improvement initiatives aimed at improving PCI outcomes, along with advances in pharmacologic and technical aspects of PCI care, we wanted to see if many more hospitals around the United States were performing safe and high-quality PCI.”

The researchers based their comparisons on data submitted to the National Cardiovascular Data Registry CathPCI. Sukul said patients needing PCI should be reassured by the results.

“Safe and appropriate PCI is performed across the nation in hospitals participating in this registry and meeting minimum volume targets,” he said.

Although the study contained a large number of procedures and hospitals, not all hospitals that perform PCI participate in the registry. Six hospitals ranked among the top 50 by U.S. News and World Report in 2015 were ineligible for the study because they either didn’t submit data or performed a low number of PCIs.

Sukul and colleagues noted their findings relate specifically to PCI and shouldn’t be generalized to other cardiac treatments.