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Decreasing in-hospital mortality of patients undergoing percutaneous coronary intervention with persistent higher mortality rates in women and minorities in the United States.

BACKGROUND
Advances in interventional techniques have been dramatic in the last 10 years. The goal of this study was to evaluate the age-adjusted in-hospital mortality rate in patients undergoing percutaneous coronary intervention (PCI) using a large database.


METHODS
The Nationwide Inpatient Sample (NIS) database was utilized to calculate the age-adjusted mortality rate for PCI from 1988 to 2004 in patients over the age of 40 retrospectively. Specific ICD-9- CM codes for PCI were used for this study. Demographic data were also analyzed and adjusted for age.


RESULTS
The mean age for these patients was 71.56 +/- 10.59 years (53.55% male). From 1988 to 1995, the age-adjusted mortality rate was stable. However, after 1995 the age-adjusted mortality rate showed persistent decline to the lowest level in 2004. (In 1988, age-adjusted mortality rate was 75.43 per 100,000 [95% CI = -7.88-158.76], in 1995, 66.83 per 100,000 [95% CI = 24.62-109.050] and in 2004, 38.38 per 100,000 [95% CI 19.53- 57.22]; p < 0.01). Total death also declined from 1.8% to 1.2%. This trend was similar across gender and ethnicities except for Asians. Furthermore, minorities and women had persistently higher mortality in comparison to males and Caucasians.


CONCLUSION
The age-adjusted in-hospital mortality rate from PCI was steady until 1995 and declined to its lowest level in 2004. Despite this decline, racial and gender disparity in regard to mortality persisted over the study years.