Observational studyClinical cardiology2021
Coronary revascularization outcomes in relation to skilled nursing facility use following hospital discharge.
Observational study in Clinical cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Evaluating the efficacy of a continuous comprehensive nursing system on postoperative hemoglobin levels and quality of life in coronary artery bypass surgery: a randomized controlled trial.Perioperative medicine (London, England) · 2025Article
- The correlation between COVID-19 vaccination and cardiac surgery: When is safe to vaccinate?Journal of cardiac surgery · 2022Article
- Coronary revascularization outcomes in relation to skilled nursing facility use following hospital discharge.Clinical cardiology · 2021Observational
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundObservational analyses comparing coronary artery bypass surgery (CABG) and percutaneous coronary intervention (PCI) among elderly or frail patients are likely biased by treatment selection. PCI is typically chosen for frail patients, while CABG is more common for patients with good recovery potential. HYPOTHESIS: We hypothesized that skilled nursing facility (SNF) use after revascularization is a measure of relative frailty associated with outcomes following coronary revascularization.
methodsWe used a 20 percent sample of Medicare beneficiaries aged 65 years or older who received inpatient PCI or CABG between 2007-2014. Key explanatory variables were the revascularization strategy and SNF use after revascularization. We used Cox regression to evaluate death and repeat revascularization within one year and logistic regression to evaluate SNF use and 30-day readmissions/death.
resultsCABG patients were 25.1 percentage points [95% confidence interval: 24.7, 25.5] more likely to use SNF following revascularization than inpatient PCI patients. SNF use was associated with a higher death rate (hazard ratio (HR): 3.19 [3.02, 3.37]) and a 16.2 percentage point (15.5, 16.9) increase in 30-day readmissions/death. Among patients with SNF use, CABG was associated with a decrease in 30-day readmissions/death compared to PCI.
conclusionsWhile CABG was associated with higher rates of SNF use and 30-day readmission/death overall, CABG was associated with significantly lower rates of 30-day readmissions/death among patients with SNF use. The findings suggest that caution is needed in treatment selection for patients at high-risk for SNF use and that selection of inpatient PCI over CABG may be associated with frailty and worse outcomes for some patients.
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