Evidence map›Paper›PMID 34898658›Full record

ArticlePloS one2021

Variation in in-hospital mortality and its association with percutaneous coronary intervention-related bleeding complications: A report from nationwide registry in Japan.

Yuichi Sawayama, Kyohei Yamaji, Shun Kohsaka, Takashi Yamamoto, Yosuke Higo, Yohei Numasawa, Taku Inohara, Hideki Ishii, Tetsuya Amano, Yuji Ikari and 1 more

Abstract read
In one paragraph

Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. The Negative Influence and Adverse Outcome of Red Blood Cell Transfusion in Contemporary Percutaneous Coronary Interventions.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2025
    Review
  2. In-hospital Outcomes and Cost Associated With Treatments for Non-ST-elevation Myocardial Infarction.Journal of the Society for Cardiovascular Angiography & Interventions
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Yuichi SawayamaDepartment of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan.ORCID 0000-0002-9409-0056
Kyohei YamajiDivision of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Shun KohsakaDepartment of Cardiology, Keio University School of Medicine, Tokyo, Japan.
Takashi YamamotoDepartment of Cardiovascular Medicine, Kohka Public Hospital, Kohka, Japan.
Yosuke HigoDepartment of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan.
Yohei NumasawaDepartment of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.
Taku InoharaDepartment of Cardiology, Keio University School of Medicine, Tokyo, Japan.
Hideki IshiiDepartment of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan.ORCID 0000-0003-4348-0123
Tetsuya AmanoDepartment of Cardiology, Aichi Medical University, Aichi, Japan.
Yuji IkariDepartment of Cardiology, Tokai University School of Medicine, Isehara, Japan.ORCID 0000-0001-5686-4324
Yoshihisa NakagawaDepartment of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan.ORCID 0000-0002-9411-9314

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Large-scale registries have demonstrated that in-hospital mortality after percutaneous coronary intervention (PCI) varies widely across institutions. However, whether this variation is related to major procedural complications (e.g., bleeding) is unclear. In this study, institutional variation in in-hospital mortality and its association with PCI-related bleeding complications were investigated. We analyzed 388,866 procedures at 718 hospitals performed from 2017 to 2018, using data from a nationwide PCI registry in Japan. Hospitals were stratified into quintiles according to risk-adjusted in-hospital mortality (very low, low, medium, high, and very high). Incidence of bleeding complications, defined as procedure-related bleeding events that required a blood transfusion, and in-hospital mortality in patients who developed bleeding complications were calculated for each quintile. Overall, 4,048 (1.04%) in-hospital deaths and 1,535 (0.39%) bleeding complications occurred. Among patients with bleeding complications, 270 (17.6%) died during hospitalization. In-hospital mortality ranged from 0.22% to 2.46% in very low to very high mortality hospitals. The rate of bleeding complications varied modestly from 0.27% to 0.57% (odds ratio, 1.95; 95% confidence interval, 1.58-2.39). However, mortality after bleeding complications markedly increased by quintile and was 6-fold higher in very high mortality hospitals than very low mortality hospitals (29.0% vs. 4.8%; odds ratio, 12.2; 95% confidence interval, 6.90-21.7). In conclusion, institutional variation in in-hospital mortality after PCI was associated with procedure-related bleeding complications, and this variation was largely driven by differences in mortality after bleeding complications rather than difference in their incidence. These findings underscore the importance of efforts toward reducing not only bleeding complications but also, even more importantly, subsequent mortality once they have occurred.

Indexed as

AgedAged, 80 and overCoronary OcclusionDatabases, FactualFemaleHemorrhageHospital MortalityHospitalsHumansIncidenceJapanMaleMiddle AgedOdds RatioPercutaneous Coronary InterventionRegistries

Identifiers

PMID34898658
PMCPMC8668123

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.