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New York State Department of Health December 2010 - page 52 / 62

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Appendix 1

2008 Risk Factors For PCI In-Hospital/30-Day Mortality (ALL CASES)

  • e significant pre-procedural risk factors for in-hospital/30-day mortality following PCI in 2008 are presented in the

table that follows.

Roughly speaking, the odds ratio for a risk factor represents the number of times a patient with that risk factor is more likely to die in the hospital during or after PCI or after hospital discharge but within 30 days of the PCI than a patient without the risk factor, all other risk factors being the same. For example, the odds ratio for the risk factor “CHF, Current” is 1.847. is means that a patient with CHF in the past two weeks is approximately 1.847 times as likely to die in the hospital during the same admission as PCI or after hospital discharge but within 30 days of the PCI as a patient without CHF, Current who has the same other significant risk factors. e risk factors Unstable, COPD and Malignant Ventricular Arrhythmia are interpreted in the same way.

With regard to age, the odds ratio roughly represents the number of times a patient who is over age 55 is more likely to die in the hospital or after discharge but within 30 days than another patient who is one year younger, all other significant risk factors being the same. us, a patient undergoing PCI who is 68 years old has approximately 1.055 times the chance of dying in the hospital or within 30 days than a 67 year-old patient has, all other risk factors being the

same.

All patients aged 55 years or younger have roughly the same odds of dying in the hospital or after discharge but

within 30 days, if their other risk factors are identical.

Ejection fraction, which is the percentage of blood in the heart’s left ventricle that is expelled when it contracts (with more denoting a healthier heart), is subdivided into four ranges (less than 20 percent, 20 percent to 29 percent, 30 percent to 39 percent and 40 percent or more). e last range is referred to as the reference category. is means that the odds ratio that appears for the other Ejection Fraction categories in the table is relative to patients with an ejection fraction of 40 percent or more. us, a PCI patient with an ejection fraction of less than 20 percent is about 3.582 times as likely to die in the hospital or within 30 days as a patient with an ejection fraction of 40 percent or higher, all other significant risk factors being the same.

Previous MI is subdivided into seven ranges (with ST Elevation present, occurring less than twelve hours prior, twelve to twenty-three hours prior; without ST Elevation, less than six hours prior, six to twenty-three hours prior; with or without ST Elevation, one to seven days prior, eight to twenty days prior and no MI within twenty days prior to the procedure).

  • e last range is referred to as the reference category. e odds ratio for the Previous MI ranges are relative to patients

who have not had an MI within twenty days prior to PCI.

Renal failure is subdivided into five groups. ree categories represent patients with various levels of elevated creatinine, but no dialysis. e fourth category includes patients with renal failure on dialysis. All groups are relative to patients who are not on dialysis and had no pre-PCI creatinine values greater than 1.1 mg/dL.

  • ree vessels diseased refers to patients with at least a 70 percent blockage in three of the native coronary arteries

including the Left Anterior Descending (LAD), the Right Coronary Artery (RCA) and the Left Circumflex (LCx) or their major branches.

Left Main Disease refers to patients with a blockage of at least 50 percent in their Left Main Coronary Artery. is group is compared to patients who do not have a blockage of at least 50 percent in their Left Main Coronary Artery.

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