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Patients who undergo non-surgical procedures to unblock narrowed coronary arteries in hospitals without a cardiac surgery program have a higher death rate than patients who undergo the procedure in hospitals with such programs, according to a study reported in the October 27 issue of the Journal of the American Medical Association.
Dartmouth Medical School researchers studied data from 178 hospitals that performed these non-surgical procedures without onsite cardiac surgery and 943 hospitals that performed them with onsite cardiac surgery.
Patients that received the procedure in hospitals without a cardiac surgery program had a 29% higher overall risk of death than those who had the procedure in a hospital with surgical backup.
In this procedure, a balloon is used to unblock narrowed coronary arteries and a wire stent is inserted to keep the artery clear. Although it is a non-surgical procedure, complications that require emergency cardiac surgery may arise.
In the United States, hospitals with catheterization laboratories but without cardiac surgery on location are rapidly developing programs using such techniques, according to the researchers.
"Our findings suggest that the current wave to move (such procedures) into hospitals that don't have coronary artery bypass surgery programs should be questioned," said study author Dr. David Wennberg, a professor of community and family medicine at Dartmouth Medical School.
Source: Medical Week Staff week of October 30, 2004
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