Clinical InvestigationInterventional CardiologyTemporal trends in the use of intraaortic balloon pump associated with percutaneous coronary intervention in the United States, 1998-2008
Section snippets
Data source
We analyzed data provided by The Healthcare Cost and Utilization Project (HCUP),11 which is a family of health care databases that has been gathering a large collection of longitudinal hospital care data in the United States beginning in 1988. The HCUP databases combine the data collection efforts of state data organizations, hospital associations, private data organizations, and federal government to create a national pool of patient-level health care data, allowing researchers to investigate
Trends and patterns in IABP use
The overall IABP use in the United States decreased significantly during the study period from 0.99% in 1998 to 0.36% in 2008 (univariate and multivariate P for trend < .0001; Figure 2). The patients’ baseline characteristics are presented in Table I. The patients who received an IABP did not differ in age or gender compared with the non-IABP group. Compared with the non-IABP group, the IABP group appeared acutely ill with substantially higher percentages of CHF (39.4% vs 11.1%; P < .0001), AMI
Discussion
Through time, with advances in device technology, insertion technique from surgical to percutaneous and increasing operator experience, IABP has been successfully used in a wide variety of clinical settings. Although still globally used in patients with shock, accumulating data from studies have demonstrated variable results in overall use and its impact on patient mortality. To date, there have been no consistent reports on IABP use in the United States. In this large and representative data
Conclusion
Intraaortic balloon pump has traditionally been the most commonly used mechanical assist device in AMI patients complicated by shock. However, clinicians appear to be using it less in this clinical setting. Aims toward early revascularization, improvements in management of AMI from the time of symptom onset to cardiac catheterization laboratory intervention, and better primary and secondary prevention may have contributed to the downward trend in inhospital mortality rates in PCI that we
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This project was supported in part by the National Center for Advancing Translational Sciences, National Institutes of Health, through grant UL1TR000050, and the Division of Cardiology, University of Illinois, at Chicago.
The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors are solely responsible for the design and conduct of this study, all study analyses, the drafting and editing of the paper, and its final contents.