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Comparative Study
. 2019 Apr;12(4):e007564.
doi: 10.1161/CIRCINTERVENTIONS.118.007564.

Effect of Public Reporting on the Utilization of Coronary Angiography After Out-of-Hospital Cardiac Arrest

Ashwin S Nathan  1   2   3 , Rohan M Shah  4 , Sameed A Khatana  1   2   3 , Elias Dayoub  2   3 , Paula Chatterjee  2   5 , Nimesh D Desai  2   3   6 , Stephen W Waldo  7 , Robert W Yeh  8 , Peter W Groeneveld  2   3   5   9 , Jay Giri  1   2   3   9
Affiliations
Comparative Study

Effect of Public Reporting on the Utilization of Coronary Angiography After Out-of-Hospital Cardiac Arrest

Ashwin S Nathan et al. Circ Cardiovasc Interv. 2019 Apr.

Abstract

Background: Public reporting of cardiovascular outcomes has been associated with risk aversion for potentially lifesaving procedures and may have spillover effects on nonreported but related procedures.

Methods and results: A cross-sectional analysis of the utilization of coronary angiography among patients presenting with out-of-hospital cardiac arrest between 2005 and 2011 in states with public reporting of percutaneous coronary intervention outcomes (New York and Massachusetts) versus neighboring states without public reporting of percutaneous coronary intervention outcomes (Delaware, Connecticut, Maine, Vermont, Maryland, and Rhode Island) was performed using the Nationwide Inpatient Sample. We analyzed 50 125 admission records with out-of-hospital cardiac arrest between 2005 and 2011. The unadjusted rate of coronary angiography for patients presenting with out-of-hospital cardiac arrest in states with public reporting versus without public reporting was not different (20.8% versus 22.8%, P=0.35). We found no statistically significant difference in the adjusted likelihood of coronary angiography in states with public reporting, though the point estimate suggested decreased utilization (odds ratio, 0.84; 95% CI, 0.66-1.06; P=0.14). There was no difference in the adjusted likelihood of in-hospital mortality for patients presenting with out-of-hospital cardiac arrest in states with public reporting compared to states without public reporting (odds ratio, 0.98; 95% CI, 0.78-1.23; P=0.88).

Conclusions: Public reporting of percutaneous coronary intervention outcomes was associated with a nonstatistically significant reduction in the utilization of diagnostic coronary angiography, a nonreported but related procedure, for patients with out-of-hospital cardiac arrest.

Keywords: cardiac arrest; coronary angiography; mortality; percutaneous coronary intervention.

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Figures

Figure 1:
Figure 1:
Flowchart of inclusion and exclusion criteria. (PCI = percutaneous coronary intervention)
See this image and copyright information in PMC

Comment in

  • Upstream Impact of Public Reporting.
    Gupta A, Gurm HS, Kirtane AJ. Gupta A, et al. Circ Cardiovasc Interv. 2019 Apr;12(4):e007878. doi: 10.1161/CIRCINTERVENTIONS.119.007878. Circ Cardiovasc Interv. 2019. PMID: 30998387 Free PMC article. No abstract available.

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