Life expectancy in the United States has increased due to advances in health care.
Despite increased utilization of percutaneous coronary intervention (PCI), octogenarian
patients are less likely to be referred to the catheterization laboratory for coronary
interventions. This is in part due to multiple patient co-morbidities and lack of
established guidelines. We examined in-hospital clinical outcomes of octogenarian
and nonoctogenarian patients who underwent PCI in the United States. Using the National
Inpatient Sampling database, we identified all adult patients who are older than 18
years and underwent PCI. Patient were stratified by age into 2 groups, ≥80 years old
and <80 years old and in-hospital adverse outcome rates were determined. A total of
11,056,559 patients underwent PCI between the years of 2002 and 2014 and 1,544,563
patients were ≥80 years old (14%). After multivariable adjustment, patients who are
≥80 years old had higher in-hospital mortality (3.3% vs 1.3%, adjusted Odds Ratio,
1.624; 95% confidence interval, 1.602 to 1.647, p <0.0001) and longer length of stay
(median length of stay days 3, range 2 to 8 days vs median 2 days, range 1 to 4 days)
(p <0.0001). Patients ≥80 years old had a higher rate of cardiopulmonary complications,
postprocedural stroke, acute kidney injury, postprocedural thromboembolic complications,
and hemorrhage requiring transfusion. There was no difference in vascular complications
between the 2 groups. In conclusion, octogenarians who underwent PCI were at increased
risk for in-hospital mortality and morbidity compared with nonoctogenarians. The decision
to proceed with PCI in this patient population should be individualized, taking into
consideration known risk factors and patient's wishes.
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Article info
Publication history
Published online: August 08, 2019
Received in revised form:
July 15,
2019
Received:
June 12,
2019
Identification
Copyright
© 2019 Published by Elsevier Inc.
