Purpose: The purpose of this study was to determine the role of nurse sensitive variables as predictors for vascular complications after percutaneous coronary interventions (PCI), and to add knowledge for evidence based protocols.  

Background/Significance: Nurses care for nearly a million people in the United States undergoing PCI annually. Femoral artery vascular complications occur in approximately 3% of procedures, involving 30,000 people per year.

Methods:  A case-matched control design was used to study risk predictors for femoral artery vascular complications in 300 PCI patients. The research questions were (1) are: co-morbidities, selected physician sensitive, and nurse sensitive variables (time in bed, mean systolic blood pressure [MSBP] during PCI, during sheath removal, during recovery)  significant predictors of vascular complications, and (2) what percent variance in prediction of complications is accounted for by nurse sensitive variables, after controlling for co-morbid and physician sensitive variables? 

Results:  In this sample 11.7% of the variance in prediction of vascular complications was explained by co-morbidities, 7.7% by the physician sensitive variables, and 17.5% by the nurse sensitive variable of MSBP during the procedure. Seventy three percent of the complications occurred during or within two hours of the PCI.  The odds for having vascular complications increased by eight times for patients with MSBP 160 mm Hg, or higher, during the procedure (p < 0.001), and three times for those receiving heparin (usually with GP2b/3a inhibitors) versus bivalirudin (p = 0.008). Patients with a history of hypertension were 61% (p = 0.005) less likely to have complications.

Conclusions:  The results indicate that MSBP should be reduced below 160 mm Hg during PCI.  More conservative protocols of care are needed for patients who receive heparin and GP 2b/3a inhibitors.  Dichotomous data on co-morbid conditions does not predict vascular complications.