Service Lines
Service Line Focus: Risk Assessment for Cath Lab Success
Health systems are performing more percutaneous coronary intervention (PCI) procedures than ever on older adults. And while patients over age 65 now undergo more than half of all PCIs, they account for a staggering 80% of all PCI deaths. This stark reality makes it imperative that CV service line leaders revisit approaches to risk stratifying PCI patients, defining procedural success and supporting recovery.
Growth in Interventional Cardiology Comes From the 65+ Population:
Note: Analysis excludes 0–17 age group and includes the cardiovascular service line group. Sources: Fazel R et al. J Soc Cardiovasc Angiogr Interv. 2025;3:101866; Impact of Change®, 2025; HCUP National Inpatient Sample (NIS). Healthcare Cost and Utilization Project (HCUP) 2019. Agency for Healthcare Research and Quality, Rockville, MD; Proprietary Sg2 All-Payer Claims Data Set, 2022; The following 2022 CMS Limited Data Sets (LDS): Carrier, Denominator, Home Health Agency, Hospice, Outpatient, Skilled Nursing Facility; Claritas Pop-Facts®, 2025; Sg2 Analysis, 2025.
Many CV programs still don’t formally account for the fact that frailty is now the defining factor in predicting procedural outcomes. Compared to robust patients, severely frail patients experience longer hospital stays, higher rates of complications and sharply elevated mortality. It’s not just about surviving the intervention—it’s about what comes after: slower recoveries, reduced function and more frequent readmissions.
Some systems, however, are assessing frailty long before a patient enters the catheterization lab. Pre-procedure screenings now include frailty scales, gait assessments and social risk factors, and providers may opt to have geriatricians comanage older PCI patients. Elsewhere, CV teams are piloting postdischarge follow-up for older adults flagged as frail, with additional supports like nutrition consults and physical therapy referrals.
CV leaders also must recognize the complexity the aging PCI cohort creates in planning for on-campus vs off-campus cath labs. While interventional cardiology procedures continue to shift off campus, the adage “Just because you can doesn’t mean you should” applies.
Integrating simple, consistent assessments and care plans into the existing workflow not only could improve clinical results but also may align with larger goals of cost reduction, patient satisfaction and age-friendly care.
For more insights, Sg2 members can check out our CV Resource Kit. Not a member? Reach out to us at learnmore@sg2.com for information on the expert intelligence, data-driven insights and strategic perspective Sg2 offers to health systems nationwide.