Elective Percutaneous Coronary Intervention (PCI) Program Report, 2024

California Health and Safety Code §1256.01 authorizes the California Department of Public Health (CDPH) to certify hospitals that do not have on-site cardiac surgery but have met specific requirements to perform elective PCIs. The Department of Health Care Access and Information (HCAI) is required to use data collected by the American College of Cardiology (ACC)-National Cardiovascular Data Registry (NCDR) CathPCI Registry from certified hospitals to create annual reports of performance for certified hospitals.

This report provides risk-adjusted outcome measures for elective and all PCI mortality, as well as post-PCI stroke. It also includes observed counts of post-PCI emergency coronary artery bypass graft (CABG) surgery. The results reflect performance for the 24 hospitals certified to perform elective PCIs without on-site cardiac surgery, marking the ninth annual outcomes report for the Elective PCI program.

Risk-adjusted rates for emergency CABG are not calculated and therefore appear as “Not Applicable” in the Risk-Adjusted Adverse Event Rate section of the visualization. Beginning in 2018, after the NCDR implemented CathPCI Registry version 5.0, patients transferred to another health care facility for emergency CABG following PCI are no longer captured. HCAI continues to identify emergency CABG cases for certified hospitals through the HCAI Cardiac Online Reporting for California (CORC). However, the data required to calculate the statewide rate are not available in the NCDR CathPCI Registry. As a result, HCAI no longer reports risk-adjusted rates for this outcome.

“All PCIs” include elective PCIs in addition to non-elective or primary PCIs (i.e., urgent, emergency, and salvage PCIs). Both elective and non-elective PCIs are derived from NCDR’s CathPCI Registry. Although Elective PCI Program hospitals are certified to perform elective PCIs without on-site cardiac surgery, these hospitals also routinely perform non-elective PCIs. Including both elective and all PCI outcomes provides a more comprehensive overview of the range of PCIs performed at certified hospitals, from planned elective interventions to high-risk emergency procedures. Because elective PCIs represent a smaller subset of all PCIs, adverse events are often very low and may be zero in some reporting years. In such cases, evaluating all PCI adverse event rates can be more informative for consumers and stakeholders, particularly when comparing hospital performance or assessing outcomes relative to statewide rates.