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Access route selection for percutaneous coronary intervention among Vietnamese patients: Implications for in-hospital costs and outcomes

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posted on 05.05.2021, 06:03 by HTT Vu, R Norman, NM Pham, HM Pham, HTT Nguyen, QN Nguyen, LD Do, RR Huxley, Crystal Lee, TM Hoang, CM Reid
Background: Little is known about rates of access site (transradial (TRI) or transfemoral (TFI)) preference for percutaneous coronary intervention (PCI) and in-hospital costs of patients undergoing these procedures in lower-and middle-countries. Here, we report on access site use, in-hospital costs and outcomes of patients undergoing PCI in Vietnam. Methods: Information from 868 patients were included in the cohort of 1022 patients recruited into the first PCI registry in Vietnam. The total hospital costs and in-hospital outcomes of patients undergoing TRI and TFI were compared. Hospital costs were obtained from the hospital admission system, and major adverse cardiac events, major bleeding events and length of stay were identified through review of medical records. Findings: TRI was the dominant access site for interventionists (694/868 patients). The TFI group reported more lesions of the left main artery, more previous coronary artery bypass grafts and previous PCI in comparison with the TRI group (all p < 0.05). The TRI group was associated with a lower overall cost of admission (the adjusted difference was -1526.3 USD, 95% confident interval CI (-1996.2; -1056.3), shorter length of hospital stay (-2 days, CI (-2.8; -1.2)) and lower rates of major bleeding post-procedure. Procedural factors such as radial access site, left main disease, PCI ≥2 stents, and PCI ≥ 2 lesions having the most impact on the in-hospital cost of patients undergoing PCI. Interpretations: Among patients undergoing PCI, TRI was associated with lower costs and favourable clinical outcomes relative to TFI Funding: This research received partial financial support from Curtin University, Australia.

History

Publication Date

01/04/2021

Journal

The Lancet Regional Health - Western Pacific

Volume

9

Article Number

100116

Pagination

7p.

Publisher

Elsevier BV

ISSN

2666-6065

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The Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.

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