Abstract 15446: In-hospital Mortality Outcomes Between Urban and Rural Hospitals for Patients Undergoing Percutaneous Coronary Intervention

Abstract

Introduction: Percutaneous Coronary Intervention (PCI) is among the most common procedures in cardiology. However, in-hospital mortality for patients undergoing PCI procedures based on hospital location and teaching status needs evaluation. Understanding this relationship is necessary for identifying disparities in patient outcomes for PCI procedures. Hypothesis: To evaluate whether urban teaching hospitals have lower in-hospital mortality rates for PCI procedures than urban non-teaching and rural hospitals. Methods: We used data from the 2016 National Inpatient Sample (NIS) database to identify inpatient PCI hospitalizations. Hospitals were categorized as rural, urban teaching, and urban non-teaching. We used multivariable logistic regression to evaluate in-hospital mortality for PCI by hospital location and teaching status. We controlled for age, sex, race, length of stay, and comorbidities. Analyses accounted for the survey weighting design. Results: We identified 80,793 unweighted inpatient hospitalizations for PCI, representing 390,070 admissions when accounting for the survey weighting design. Of the 390,090 admissions, there were 21,020 (5.4%) from rural hospitals and 369,070 from urban hospitals (94.6%). Within the urban hospitals, there were 267,365 (72.4%) admissions from teaching hospitals and 101,705 (27.6%) admissions from non-teaching hospitals. There were no significant differences for in-hospital mortality between urban (6885 +/- 224.2 deaths) and rural hospitals (355 +/- 52.6 deaths, p= 0.6351). In-hospital mortality was found to be lower at urban teaching hospitals (4895 +/- 187.1 deaths) than at urban non-teaching hospitals (1990 +/- 123.5 deaths, p= 0.0096). Conclusions: In-hospital mortality for inpatient PCI procedures was not associated with hospital location, but rather with hospital teaching status. Urban teaching hospitals had lower rates of in-hospital mortality for PCI procedures than urban non-teaching hospitals. Further investigation to identify causes for this discrepancy is necessary.