The appropriateness of percutaneous transluminal coronary angioplasty in Korea

Yim, Jun; Khang, Young-Ho; Oh, Byung Hee; Kim, Yong Ik; Kim, Choon Yul

doi:10.1016/j.ijcard.2003.03.028

Cited by 6 publications

(2 citation statements)

References 24 publications

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“…Panel members rated 204 indications and disagreed about just 6.4% of them. This percentage is low but is similar to that found in other studies applying the RAM methodology [21][22][23]. The disagreement is especially stated for indications on adaptation of laparoscopic surgery.…”

Section: Discussionsupporting

confidence: 84%

Assessing the appropriate use of laparoscopic surgery for hepatobiliary diseases

Molina-Linde

Lacalle-Remigio

Villegas

et al. 2009

J Hepatobiliary Pancreat Surg

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Section: Discussionsupporting

confidence: 84%

Assessing the appropriate use of laparoscopic surgery for hepatobiliary diseases

Molina-Linde

Lacalle-Remigio

Villegas

et al. 2009

J Hepatobiliary Pancreat Surg

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“…Since early revascularization has been proven to improve the clinical outcome of AMI patients, the revascularization rate has increased in many countries, including Korea [ 10 , 11 ]. Shortening the initiation time for revascularization is also associated with improved outcomes in AMI patients [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Admission route and use of invasive procedures during hospitalization for acute myocardial infarction: analysis of 2007-2011 National Health Insurance database

et al. 2015

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OBJECTIVESThe goal of this study was to investigate trends in admission to the emergency department and the use of invasive or surgical procedures during hospitalization for acute myocardial infarction (AMI) in Korea.METHODSThe National Health Insurance (NHI) claims database between 2007 and 2011 was used. We identified all admission claims that included codes from the tenth revision of the International Classification of Diseases beginning with I21 as the primary or secondary diagnosis. Information about the admission route, admission date, discharge date, and whether coronary artery angiography, angioplasty, or bypass surgery was performed was also obtained from the NHI database.RESULTSOf the 513,886 relevant admission claims over the five years encompassed by this study, 295,001 discrete episodes of admission for AMI were identified by analyzing the date and length of each admission and the interval between admissions. The number of AMI admissions gradually decreased from 66,883 in 2007 to 47,656 in 2011. The number and proportion of admissions through the emergency department also decreased from 38,118 (57.0%) in 2007 to 24,001 (50.4%) in 2011. However, during the same period, admissions in which invasive or surgical procedures were performed increased from 15,342 (22.9%) to 17,505 (36.7%).CONCLUSIONSThe reported numbers of emergency department visits and admissions for AMI decreased from 2007 to 2011. However, only a small portion of the patients underwent invasive or surgical procedures during hospitalization, although the number of admissions involving invasive or surgical procedures has increased. These findings suggest that simply counting the number of admission claims cannot provide valid information on trends in AMI occurrence.

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Appropriateness of Percutaneous Coronary Intervention

Chan¹,

Patel²,

Klein³

et al. 2011

JAMA

277

221

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Context Despite the widespread use of percutaneous coronary intervention (PCI), the appropriateness of these procedures in contemporary practice is unknown. Objective To assess the appropriateness of PCI in the United States. Design, Setting, and Patients Multicenter, prospective study of patients within the National Cardiovascular Data Registry undergoing PCI between July 1, 2009, and September 30, 2010, at 1091 US hospitals. The appropriateness of PCI was adjudicated using the appropriate use criteria for coronary revascularization. Results were stratified by whether the procedure was performed for an acute (ST-segment elevation myocardial infarction, non–ST-segment elevation myocardial infarction, or unstable angina with high-risk features) or nonacute indication. Main Outcome Measures Proportion of acute and nonacute PCIs classified as appropriate, uncertain, or inappropriate; extent of hospital-level variation in inappropriate procedures. Results Of 500 154 PCIs, 355 417 (71.1%) were for acute indications (ST-segment elevation myocardial infarction, 103 245 [20.6%]; non–ST-segment elevation myocardial infarction, 105 708 [21.1%]; high-risk unstable angina, 146 464 [29.3%]), and 144 737 (28.9%) for nonacute indications. For acute indications, 350 469 PCIs (98.6%) were classified as appropriate, 1055 (0.3%) as uncertain, and 3893 (1.1%) as inappropriate. For nonacute indications, 72 911 PCIs (50.4%) were classified as appropriate, 54 988 (38.0%) as uncertain, and 16 838 (11.6%) as inappropriate. The majority of inappropriate PCIs for nonacute indications were performed in patients with no angina (53.8%), low-risk ischemia on noninvasive stress testing (71.6%), or suboptimal (≤1 medication) antianginal therapy (95.8%). Furthermore, although variation in the proportion of inappropriate PCI across hospitals was minimal for acute procedures, there was substantial hospital variation for nonacute procedures (median hospital rate for inappropriate PCI, 10.8%; interquartile range, 6.0%–16.7%). Conclusions In this large contemporary US cohort, nearly all acute PCIs were classified as appropriate. For nonacute indications, however, 12% were classified as inappropriate, with substantial variation across hospitals.

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The appropriateness of percutaneous transluminal coronary angioplasty in Korea

Cited by 6 publications

References 24 publications

Assessing the appropriate use of laparoscopic surgery for hepatobiliary diseases

Assessing the appropriate use of laparoscopic surgery for hepatobiliary diseases

Admission route and use of invasive procedures during hospitalization for acute myocardial infarction: analysis of 2007-2011 National Health Insurance database

Appropriateness of Percutaneous Coronary Intervention

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