Summary of PCI with ACS Model based on California Inpatient Discharge Data, 2012-2013
Outcome: | MACCE (Multiple Adverse Cardiovascular and Cerebral Events) |
| This outcome is determined based on the occurrence of 1 or more of the following events after the Index PCI or a Subsequent Connected Inpatient Admission: - Death during the PCI admission or during an inpatient re-admission connected to the index admission via acute transfer; disposition code '11' is used to identify in-hospital deaths.
- Post OP Myocardial Infarction (MI) defined as MI during the PCI admission that was not present at admission or an MI during an inpatient re-admission connected to the PCI admission via acute transfer; ICD-9-CM codes used to identify MIs: 410.xx.
- Post OP Stroke defined as stroke during the PCI admission that was not present at admission or stroke during an inpatient re-admission connected to the PCI admission via acute transfer; ICD-9-CM codes used to identify Strokes: 997.02, 433.01, 433.11, 433.21, 433.31, 433.81, 433.91, 434.01, 434.11, 434.91.
- Re-Intervention defined as any cardiac surgery that occurred on or after the index PCI during the index PCI admission or a connected acute inpatient admission, or a PCI that occurred after the index PCI during the index PCI admission or a connected un-scheduled acute inpatient admission. Any procedure in the range 35.xx-38.xx that was performed using ECC (ICD-9-CM procedure code 39.61) or off-pump CABG procedure (36.1x) is considered a re-intervention. Furthermore, any PCI (36.01, 36.02, 36.05, 36.06, 36.09, 00.66) that is performed after the index PCI either during the index admission or a subsequent connected un-scheduled acute inpatient admission is considered a re-intervention.
All events are weighted equally. |
Model Statistics: |
| Number of Observations: 50,415 |
| % of Observations with Outcome: 10.1% |
| C-statistic: 0.689 | Pseudo-R2: 10.7 | Hosmer-Lemeshow P-Value: 0.160 |
Model Details: |
|
Risk Factor | N Cases | % Events | Estimate | Standard Error | Wald Chi2 | P-value | Odds Ratio (OR) | Lower 95% CL for OR | Upper 95% CL for OR |
Intercept | | | -2.9 | 0.1 | 2955.8 | 0.000 | | | |
Age at Admission | 18-<50 | 7,089 | 7.3 | -0.3 | 0.1 | 20.2 | 0.000 | 0.8 | 0.7 | 0.9 |
| 50-<55 | 4,559 | 7.9 | -0.2 | 0.1 | 10.3 | 0.001 | 0.8 | 0.7 | 0.9 |
| 55-<60 | 6,897 | 8.9 | -0.1 | 0.1 | 4.7 | 0.030 | 0.9 | 0.8 | 1.0 |
| 60-<65 | 7,294 | 10.0 | -0.0 | 0.1 | 0.3 | 0.598 | 1.0 | 0.9 | 1.1 |
| 65-<70 | 6,842 | 10.3 | | | | Reference | | | |
| 70-<75 | 5,503 | 10.8 | 0.0 | 0.1 | 0.0 | 0.892 | 1.0 | 0.9 | 1.1 |
| 75-<80 | 4,734 | 11.7 | 0.1 | 0.1 | 2.9 | 0.091 | 1.1 | 1.0 | 1.3 |
| 80 or older | 7,497 | 13.4 | 0.2 | 0.1 | 16.8 | 0.000 | 1.3 | 1.1 | 1.4 |
Patient Sex | Male | 35,546 | 9.9 | | | | Reference | | | |
| Female | 14,869 | 10.4 | -0.1 | 0.0 | 3.8 | 0.053 | 0.9 | 0.9 | 1.0 |
Race | Other race | 7,380 | 11.0 | 0.1 | 0.0 | 3.2 | 0.072 | 1.1 | 1.0 | 1.2 |
| White | 35,193 | 10.0 | | | | Reference | | | |
| Black | 2,914 | 7.8 | -0.2 | 0.1 | 7.4 | 0.007 | 0.8 | 0.7 | 0.9 |
| Asian/Pacific Islander | 4,928 | 10.5 | 0.0 | 0.1 | 0.6 | 0.456 | 1.0 | 0.9 | 1.2 |
Ethnicity | Non-Hispanic | 40,256 | 9.7 | | | | Reference | | | |
| Hispanic | 10,159 | 11.4 | 0.2 | 0.0 | 13.6 | 0.000 | 1.2 | 1.1 | 1.3 |
Acute MI Present at Scheduled Admission | 4,632 | 6.3 | -0.2 | 0.1 | 7.1 | 0.008 | 0.8 | 0.7 | 1.0 |
Atrial Fibrillation and Flutter | 4,989 | 14.2 | 0.1 | 0.0 | 6.5 | 0.011 | 1.1 | 1.0 | 1.2 |
Cardiogenic Shock | 2,859 | 38.8 | 1.7 | 0.0 | 1524.3 | 0.000 | 5.7 | 5.2 | 6.2 |
Cardiomyopathy | 2,092 | 14.6 | 0.2 | 0.1 | 6.8 | 0.009 | 1.2 | 1.0 | 1.4 |
Heart Failure | 10,256 | 15.4 | 0.3 | 0.0 | 55.7 | 0.000 | 1.3 | 1.2 | 1.4 |
HX Sudden Cardiac Arrest (Begin 2007) | 287 | 16.9 | 0.3 | 0.2 | 3.2 | 0.074 | 1.4 | 1.0 | 1.9 |
Chronic Lung Disease | 4,532 | 12.8 | 0.2 | 0.1 | 8.8 | 0.003 | 1.2 | 1.1 | 1.3 |
Cerebrovascular Disease | 1,866 | 15.7 | 0.4 | 0.1 | 35.5 | 0.000 | 1.5 | 1.3 | 1.7 |
Diabetes | 18,283 | 11.5 | 0.1 | 0.0 | 19.0 | 0.000 | 1.2 | 1.1 | 1.2 |
Dialysis | 636 | 10.3 | -0.2 | 0.1 | 1.7 | 0.196 | 0.8 | 0.6 | 1.1 |
Peripheral Vascular Disease | 5,062 | 12.2 | 0.0 | 0.1 | 0.2 | 0.680 | 1.0 | 0.9 | 1.1 |
Renal Failure | 8,650 | 13.7 | 0.2 | 0.0 | 33.8 | 0.000 | 1.3 | 1.2 | 1.4 |
Status of Procedure Urgent | 23,745 | 12.9 | 0.6 | 0.0 | 279.7 | 0.000 | 1.8 | 1.7 | 1.9 |
|
Notes: |
| If a patient had more than one surgery event of the same type on different dates during the index admission, only the surgery on the earliest date is included for fitting the model. |
| CL: Confidence Limit |