Variation in Arterial Access for Invasive Coronary Procedures in New Zealand: A National Analysis (ANZACS-QI 5)

Barr, P.; Smyth, D.; Harding, Scott; El‐Jack, Seif; Williams, Michael J.A.; Devlin, G.; Stewart, Jim; Flynn, C.; Lee, M.; Kerr, Andrew

doi:10.1016/j.hlc.2015.10.009

Cited by 4 publications

(3 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…23,25 In addition, routine use of radial access catheterisation that has increased in New Zealand has facilitated shorter recovery times. 20,21,26,27 Earlier coronary angiography supports the rapid increase in earlier discharge in the large proportion of patients undergoing angiography who receive definitive revascularisation.…”

Section: Discussionmentioning

confidence: 98%

“…Other strategies include protocols to increase efficiency of ambulance, helicopter and hospital transfers; building additional cardiac catheterisation laboratories with geographic considerations, streamlining STEMI patient flow from door to catheterisation laboratory and intervention 23,25 . In addition, routine use of radial access catheterisation that has increased in New Zealand has facilitated shorter recovery times 20,21,26,27 . Earlier coronary angiography supports the rapid increase in earlier discharge in the large proportion of patients undergoing angiography who receive definitive revascularisation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Increases in early discharge following acute coronary syndrome hospitalisations and associated clinical outcomes in New Zealand between 2006 and 2015: ANZACS‐QI‐43 study

Wang

Grey

Jiang

et al. 2021

Internal Medicine Journal

View full text Add to dashboard Cite

Background International guidelines recommend early discharge for uncomplicated acute coronary syndrome (ACS) patients within 3 days; however, there is a paucity of contemporary literature regarding the safety of this strategy. Aims To report the trends in the proportion of ACS hospitalisations discharged within 3 days and their outcomes in New Zealand. Methods ACS hospitalisations 2006–2015 using national routinely collected data were categorised by length of stay (LOS) into ≤3, 4–5 and >5 days, excluding deaths during the index admission. Trend analysis of death, cardiovascular and bleeding events and their composites (net adverse clinical events) at 30‐day and 1‐year post‐discharge were performed using generalised linear mixed regression models adjusting for covariates by LOS subgroups. Results Among 130 037 ACS hospitalisations, LOS ≤ 3 days increased from 32% in 2006 to 44% in 2016. This trend was observed for all demographics, ACS subtypes and management strategies. Event rates at 30 days and 1 year were the lowest for the LOS ≤3 days subgroup (all‐cause mortality 1.6% and 9.1% respectively). Thirty‐day and 1‐year all‐cause mortality rates were unchanged over time for this subgroup (adjusted odds ratio (95% confidence interval) of 1.011 (0.985–1.038) and 0.991 (0.979–1.003)), while net adverse clinical event rates significantly decreased (0.962 (0.950–0.973) and 0.972 (0.964–0.980) respectively). Conclusion There was a substantial increase in early discharge post‐ACS over 10 years. These patients were associated with reduction in adverse clinical events up to 1 year and no increase in all‐cause mortality. These findings from a comprehensive national register suggest that guideline recommendations on early discharge after uncomplicated ACS are safe and appropriate.

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Increases in early discharge following acute coronary syndrome hospitalisations and associated clinical outcomes in New Zealand between 2006 and 2015: ANZACS‐QI‐43 study

Wang

Grey

Jiang

et al. 2021

Internal Medicine Journal

View full text Add to dashboard Cite

show abstract

“…1–5 The adoption rate for TRA in the United States (US) has been much slower, with only 28% of PCIs being performed transradially in recent reports from the NCDR ® –CathPCI ® registry. 6 This relatively slower rate of adoption occurs despite growing evidence demonstrating improved outcomes with TRA, particularly in patients presenting with an acute coronary syndrome.…”

Section: Introductionmentioning

confidence: 99%

Patient Versus Physician Variation in Use of Transradial Percutaneous Coronary Intervention

Shamim

Tang²,

Safley

et al. 2017

The American Journal of Cardiology

View full text Add to dashboard Cite

The prevalence of radial access for transradial catheterization remains low in the US, occurring in only 28% of cases in the National Cardiovascular Data Registry (NCDR®) CathPCI®. It is unknown whether the low adoption rate has been influenced by patient characteristics, or is more operator dependent. In a 10-center study, we compared clinical and demographic characteristics among 323 radial and 1506 femoral access PCIs performed by 65 interventionists capable of radial percutaneous intervention (PCI). We created a hierarchical logistic regression model to identify operator and patient characteristics associated with radial PCI and the median rate ratio to quantify the variation across operators. A subset was interviewed to assess health literacy and preferences in shared medical decision-making. Radial access was used in 17.7% of patients. Patient factors associated with lower rate of radial PCI were prior PCI (33.4% vs 41.4% P=0.008), history of Coronary Artery Bypass Graft (8.4% vs 23.0% P <0.001) and Chronic Total Occlusion PCI (10.2% vs 17.9% P <0.001). Operator characteristics associated with lower rate of radial PCI are being older, being longer in practice, lower number of publications and Southern practice location. The range of radial use across operators was 1– 99% and the median rate ratio was 1.97. Patients with radial access had lower health literacy, as assessed by the REALM score (6.6±2.6 vs 7.1±2.0, p= 0.03) but did not differ in their preferences for shared decision-making. In conclusion our study demonstrates a high degree of variability of radial access for PCI among different operators, with few differences in patient characteristics, suggesting that improvement efforts should focus on operators.

show abstract

Ethnic Differences in Coronary Revascularisation following an Acute Coronary Syndrome in New Zealand: A National Data-linkage Study (ANZACS-QI 12)

Grey

Jackson

Wells

et al. 2016

Heart, Lung and Circulation

View full text Add to dashboard Cite

Variation in Arterial Access for Invasive Coronary Procedures in New Zealand: A National Analysis (ANZACS-QI 5)

Cited by 4 publications

References 25 publications

Increases in early discharge following acute coronary syndrome hospitalisations and associated clinical outcomes in New Zealand between 2006 and 2015: ANZACS‐QI‐43 study

Increases in early discharge following acute coronary syndrome hospitalisations and associated clinical outcomes in New Zealand between 2006 and 2015: ANZACS‐QI‐43 study

Patient Versus Physician Variation in Use of Transradial Percutaneous Coronary Intervention

Ethnic Differences in Coronary Revascularisation following an Acute Coronary Syndrome in New Zealand: A National Data-linkage Study (ANZACS-QI 12)

Contact Info

Product

Resources

About