Measuring repeat coronary revascularisation procedures in NSW using linked hospital data.

Background Coronary revascularisation procedures are commonly undertaken. Patients may undergo more than one revascularisation procedure in their lives. There are a range of reasons for these repeat revascularisations, included planned multi-stage revascularisation, new disease in different arteries, and returning disease to the same artery. Methods Hospital data for NSW was probabilistically linked from July 2000 to June 2015 to non-coded deaths data from January 2004 to June 2016 creating longitudinal patient records over this period. A rolling follow up time of three years produced comparable trends over time. Incident procedure rates were age standardised. No information was available on the artery treated or the reason for the procedures. Rates were produced separately based on whether the incident procedure was a coronary artery bypass graft (CABG) or angioplasty procedure. Results Repeat revascularisation rates were higher in in patients initially receiving an angioplasty (24%, 28% and 32% for one, two or three year follow up periods in 2011-12) compared with CABG procedures 4%, 6% and 7% respectively). Rates were similar for males (19% in 2011-12) and females (18% in 2011-12) for one-year follow-up but the incidence of procedures was higher among males with 9,786 procedures compared to 3,159 procedures. Conclusions Repeat cardiac revascularisation procedures are more common after angioplasty (with or without stent) and within the same year as the initial procedure. There were no gender differences in repeat procedure rates. Further research adjusting for comorbidities and discussion with clinicians is needed to understand the reasons behind the difference in repeat rates.

Rhydwyn McGuire