Association between Public Reporting of Outcomes and the Use of Mechanical Circulatory Support in Patients with Cardiogenic Shock
Risk-averse behavior has been reported among physicians and facilities treating cardiogenic shock in states with public reporting. Our objective was to evaluate if public reporting leads to a lower use of mechanical circulatory support in cardiogenic shock. We conducted a retrospective study with th...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2019/3276521 |
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| author | Vikas Singh Rodrigo Mendirichaga Parth Bhatt Ghanshyambhai Savani Anil K. Jonnalagadda Igor Palacios Mauricio G. Cohen William W. O’Neill |
| author_facet | Vikas Singh Rodrigo Mendirichaga Parth Bhatt Ghanshyambhai Savani Anil K. Jonnalagadda Igor Palacios Mauricio G. Cohen William W. O’Neill |
| author_sort | Vikas Singh |
| collection | DOAJ |
| description | Risk-averse behavior has been reported among physicians and facilities treating cardiogenic shock in states with public reporting. Our objective was to evaluate if public reporting leads to a lower use of mechanical circulatory support in cardiogenic shock. We conducted a retrospective study with the use of the National Inpatient Sample from 2005 to 2011. Hospitalizations of patients ≥18 years old with a diagnosis of cardiogenic shock were included. A regional comparison was performed to identify differences between reporting and nonreporting states. The main outcome of interest was the use of mechanical circulatory support. A total of 13043 hospitalizations for cardiogenic shock were identified of which 9664 occurred in reporting and 3379 in nonreporting states (age 69.9 ± 0.4 years, 56.8% men). Use of mechanical circulatory support was 32.8% in this high-risk population. Odds of receiving mechanical circulatory support were lower (OR 0.50; 95% CI 0.43–0.57; p<0.01) and in-hospital mortality higher (OR 1.19; 95% CI 1.06–1.34; p<0.01) in reporting states. Use of mechanical circulatory support was also lower in the subgroup of patients with acute myocardial infarction and cardiogenic shock in reporting states (OR 0.61; 95% CI 0.51–0.72; p<0.01). In conclusion, patients with cardiogenic shock in reporting states are less likely to receive mechanical circulatory support than patients in nonreporting states. |
| format | Article |
| id | doaj-art-411fc366f30d426c8f64760dc88c6050 |
| institution | Kabale University |
| issn | 0896-4327 1540-8183 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj-art-411fc366f30d426c8f64760dc88c60502025-08-20T03:55:35ZengWileyJournal of Interventional Cardiology0896-43271540-81832019-01-01201910.1155/2019/32765213276521Association between Public Reporting of Outcomes and the Use of Mechanical Circulatory Support in Patients with Cardiogenic ShockVikas Singh0Rodrigo Mendirichaga1Parth Bhatt2Ghanshyambhai Savani3Anil K. Jonnalagadda4Igor Palacios5Mauricio G. Cohen6William W. O’Neill7University of Louisville Medical School, Louisville, KY, USABoston Medical Center, Boston University School of Medicine, Boston, MA, USATexas Tech University Health Sciences Center, Amarillo, TX, USABaystate Medical Center, University of Massachusetts, Springfield, MA, USAMedstar Washington Hospital Center, Washington, DC, USAMassachusetts General Hospital, Harvard Medical School, Boston, MA, USAUniversity of Miami Miller School of Medicine, Miami, FL, USAHenry Ford Hospital, Detroit, MI, USARisk-averse behavior has been reported among physicians and facilities treating cardiogenic shock in states with public reporting. Our objective was to evaluate if public reporting leads to a lower use of mechanical circulatory support in cardiogenic shock. We conducted a retrospective study with the use of the National Inpatient Sample from 2005 to 2011. Hospitalizations of patients ≥18 years old with a diagnosis of cardiogenic shock were included. A regional comparison was performed to identify differences between reporting and nonreporting states. The main outcome of interest was the use of mechanical circulatory support. A total of 13043 hospitalizations for cardiogenic shock were identified of which 9664 occurred in reporting and 3379 in nonreporting states (age 69.9 ± 0.4 years, 56.8% men). Use of mechanical circulatory support was 32.8% in this high-risk population. Odds of receiving mechanical circulatory support were lower (OR 0.50; 95% CI 0.43–0.57; p<0.01) and in-hospital mortality higher (OR 1.19; 95% CI 1.06–1.34; p<0.01) in reporting states. Use of mechanical circulatory support was also lower in the subgroup of patients with acute myocardial infarction and cardiogenic shock in reporting states (OR 0.61; 95% CI 0.51–0.72; p<0.01). In conclusion, patients with cardiogenic shock in reporting states are less likely to receive mechanical circulatory support than patients in nonreporting states.http://dx.doi.org/10.1155/2019/3276521 |
| spellingShingle | Vikas Singh Rodrigo Mendirichaga Parth Bhatt Ghanshyambhai Savani Anil K. Jonnalagadda Igor Palacios Mauricio G. Cohen William W. O’Neill Association between Public Reporting of Outcomes and the Use of Mechanical Circulatory Support in Patients with Cardiogenic Shock Journal of Interventional Cardiology |
| title | Association between Public Reporting of Outcomes and the Use of Mechanical Circulatory Support in Patients with Cardiogenic Shock |
| title_full | Association between Public Reporting of Outcomes and the Use of Mechanical Circulatory Support in Patients with Cardiogenic Shock |
| title_fullStr | Association between Public Reporting of Outcomes and the Use of Mechanical Circulatory Support in Patients with Cardiogenic Shock |
| title_full_unstemmed | Association between Public Reporting of Outcomes and the Use of Mechanical Circulatory Support in Patients with Cardiogenic Shock |
| title_short | Association between Public Reporting of Outcomes and the Use of Mechanical Circulatory Support in Patients with Cardiogenic Shock |
| title_sort | association between public reporting of outcomes and the use of mechanical circulatory support in patients with cardiogenic shock |
| url | http://dx.doi.org/10.1155/2019/3276521 |
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