Hospital resources consumed in treating complications associated with percutaneous coronary interventions

Nearly 9.5% of all Medicare beneficiaries who undergo a percutaneous coronary intervention (PCI) procedure develop > or =1 of 7 acute complications. This study used 2 approaches (regression analysis and propensity-matched samples) to estimate the cost of selected complications, based on administrative data from 335,477 Medicare beneficiaries who underwent PCI during a hospitalization in fiscal year 2002. Selected complications included hospital mortality, emergency/urgent coronary artery bypass surgery, postoperative stroke, acute renal failure, vascular complications, septicemia, and adult respiratory distress syndrome. The observed average cost of a PCI hospitalization for patients who did not develop complications was 13,861 dollars +/- 9,635 dollars, with an average length of stay of 3.0 +/- 3.2 days, compared with 26,807 dollars +/- 27,596 dollars and 8.0 +/- 8.9 days for patients who did develop complications. Estimates of the adjusted incremental hospital cost of treating any acute complication except death varied from a high of 33,030 dollars for patients who developed septicemia to a low of 4,278 dollars for those who developed vascular complications, whereas estimates of the incremental length of stay ranged from a high of 12.3 days for patients who had septicemia to a low of 1.8 days for patients who had vascular complications. In conclusion, we found that the incremental hospital resources that are consumed to treat patients with acute PCI complications are large compared with the cost of an uncomplicated PCI hospitalization.