Temporal trends in relative survival following percutaneous coronary intervention.
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Coronary Artery Disease
/ mortality
England
/ epidemiology
Female
Humans
Male
Middle Aged
Mortality
/ trends
Percutaneous Coronary Intervention
/ mortality
Registries
Sex Distribution
State Medicine
Survival Analysis
Time Factors
Wales
/ epidemiology
Young Adult
coronary intervention
quality in health care
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
19 02 2019
19 02 2019
Historique:
entrez:
21
2
2019
pubmed:
21
2
2019
medline:
11
3
2020
Statut:
epublish
Résumé
Percutaneous coronary intervention (PCI) has seen substantial shifts in patient selection in recent years that have increased baseline patient mortality risk. It is unclear to what extent observed changes in mortality are attributable to background mortality risk or the indication and selection for PCI itself. PCI-attributable mortality can be estimated using relative survival, which adjusts observed mortality by that seen in a matched control population. We report relative survival ratios and compare these across different time periods. National Health Service PCI activity in England and Wales from 2007 to 2014 is considered using data from the British Cardiovascular Intervention Society PCI Registry. Background mortality is as reported in Office for National Statistics life tables. Relative survival ratios up to 1 year are estimated, matching on patient age, sex and procedure date. Estimates are stratified by indication for PCI, sex and procedure date. 549 305 procedures were studied after exclusions for missing age, sex, indication and mortality status. Comparing from 2007 to 2008 to 2013-2014, differences in crude survival at 1 year were consistently lower in later years across all strata. For relative survival, these differences remained but were smaller, suggesting poorer survival in later years is partly due to demographic characteristics. Relative survival was higher in older patients. Changes in patient demographics account for some but not all of the crude survival changes seen during the study period. Relative survival is an under-used methodology in interventional settings like PCI and should be considered wherever survival is compared between populations with different demographic characteristics, such as between countries or time periods.
Identifiants
pubmed: 30782913
pii: bmjopen-2018-024627
doi: 10.1136/bmjopen-2018-024627
pmc: PMC6398900
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e024627Subventions
Organisme : Medical Research Council
ID : MC_PC_13042
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/K006665/1
Pays : United Kingdom
Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Comput Biol Med. 2007 Dec;37(12):1741-9
pubmed: 17582396
Lancet. 2015 Mar 28;385(9974):1206-18
pubmed: 25479696
BMC Cardiovasc Disord. 2014 Jun 02;14:71
pubmed: 24893930
Eur Heart J Acute Cardiovasc Care. 2019 Feb;8(1):68-77
pubmed: 28691534
Heart. 2016 Jan 5;102(4):313-319
pubmed: 26732182
Kidney Int. 2008 Oct;74(8):994-7
pubmed: 18633346
J Am Heart Assoc. 2017 Oct 17;6(10):
pubmed: 29042426
Int J Epidemiol. 2010 Apr;39(2):598-610
pubmed: 20142331
Comput Methods Programs Biomed. 2006 Mar;81(3):272-8
pubmed: 16510208
JAMA. 2015 Nov 17;314(19):2045-53
pubmed: 26551163
Eur Heart J Qual Care Clin Outcomes. 2015 Nov 1;1(2):85-91
pubmed: 29474594
Heart. 2015 May;101 Suppl 3:1-13
pubmed: 26041756
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2016 Jun;59(6):783-8
pubmed: 27188620
Rev Esp Cardiol (Engl Ed). 2016 Dec;69(12):1180-1189
pubmed: 27818146
Eur Heart J Acute Cardiovasc Care. 2015 Dec;4(6):537-54
pubmed: 25214638
Circ Cardiovasc Interv. 2018 Mar;11(3):e006062
pubmed: 29540493
Eur J Cancer. 2008 Nov;44(17):2661-7
pubmed: 18819791
Eur Heart J. 2008 Apr;29(7):941-7
pubmed: 18326008
EuroIntervention. 2013 Aug 22;9(4):469-76
pubmed: 23965352
Circ Cardiovasc Qual Outcomes. 2017 Jun;10(6):
pubmed: 28619724
Heart. 2016 Dec 15;102(24):1945-1952
pubmed: 27550425
Catheter Cardiovasc Interv. 2013 Aug 1;82(2):E69-111
pubmed: 23653399
PLoS One. 2016 Apr 22;11(4):e0154025
pubmed: 27105207
Cancer Epidemiol. 2012 Feb;36(1):16-21
pubmed: 21840284
Heart. 2016 Aug 15;102(16):1287-95
pubmed: 27056968
Cancer Chemother Rep. 1966 Mar;50(3):163-70
pubmed: 5910392
J Am Coll Cardiol. 2013 Nov 19;62(21):1931-1947
pubmed: 24036027
BMC Med Res Methodol. 2015 Aug 15;15:64
pubmed: 26275405
Rev Port Cardiol. 2015 Nov;34(11):673-81
pubmed: 26603054
Am Heart J. 2014 May;167(5):666-73
pubmed: 24766976
J Am Coll Cardiol. 2017 Mar 21;69(11):1427-1450
pubmed: 28025065
Eur Heart J. 2014 Oct 1;35(37):2541-619
pubmed: 25173339
Natl Cancer Inst Monogr. 1961 Sep;6:101-21
pubmed: 13889176
Circulation. 2017 Mar 7;135(10):e146-e603
pubmed: 28122885
Am J Cardiol. 2017 Jan 15;119(2):210-216
pubmed: 27816119
J Am Heart Assoc. 2017 Mar 20;6(3):
pubmed: 28320749