Clinical and Economic Burden of Percutaneous Coronary Intervention in Hospitalized Young Adults in the United States,...

Area of Science:

• Cardiovascular Medicine
• Health Economics
• Public Health

Background:

• Percutaneous coronary intervention (PCI) in young adults (18-45 years) is understudied, despite potential clinical and economic implications.
• Understanding trends in PCI utilization, outcomes, and costs in this demographic is crucial for healthcare planning.

Purpose of the Study:

• To analyze trends in PCI volume, in-hospital mortality, length of stay, and healthcare expenditure among US adults aged 18-45 from 2004 to 2018.
• To identify factors associated with in-hospital mortality and assess demographic disparities in PCI outcomes.

Main Methods:

• Utilized the National Inpatient Sample database (2004-2018) for weighted analysis of national estimates.
• Identified 558,611 PCI cases in adults aged 18-45.
• Analyzed trends in PCI volume, mortality, length of stay, costs, and comorbidities, including risk-adjusted mortality.

Main Results:

• Annual PCI volume decreased significantly (41.6 to 21.9 per 100,000), primarily in non-myocardial infarction cases.
• In-hospital mortality increased (crude and risk-adjusted) from 2004-2018, with higher rates in women (1.12% vs 0.78%).
• Prevalence of cardiometabolic comorbidities, smoking, and drug abuse increased; costs rose to $24,173 (inflation-adjusted).

Conclusions:

• Despite reduced PCI volumes in young adults, there was an increase in mortality and clinical comorbidities.
• Significant demographic disparities exist, with women facing higher in-hospital mortality.
• The findings underscore the need for targeted interventions and further research into PCI outcomes for younger populations.