Mamas Mamas m.mamas@keele.ac.uk
Hospital procedural volume and outcomes with catheter-directed intervention for pulmonary embolism: a nationwide analysis.
Mamas
Authors
Abstract
AIMS: There is limited data on the association between hospital catheter-directed intervention (CDI) volume and outcomes among patients with acute pulmonary embolism (PE). METHODS AND RESULTS: The Nationwide Readmissions Database years 2016-2019 was utilized to identify hospitalizations undergoing CDI for acute PE. Hospitals were divided into tertiles based on annual CDI volume; low-volume (1-3 procedures), moderate-volume (4-12 procedures) and high-volume (>12 procedures). The primary outcome was all-cause in-hospital mortality. Among 1?436?382 PE admissions, 2.6% underwent CDI; 5.6% were in low-volume, 17.3% in moderate-volume and 77.1% in high-volume hospitals. There was an inverse relationship between hospital CDI volume and in-hospital mortality (coefficient??-0.344, P?<?0.001). On multivariable regression analysis, hospitals with high CDI volume were associated with lower in-hospital mortality compared with hospitals with low CDI volume (adjusted odds ratio [OR] 0.71; 95% confidence interval [CI] 0.53, 0.95). Additionally, there was an inverse association between CDI volume and length of stay (LOS) (regression coefficient -0.023, 95% CI -0.027, -0.019) and cost (regression coefficient -74.6, 95% CI -98.8, -50.3). There were no differences in major bleeding and 30-day unplanned readmission rates between the three groups. CONCLUSION: In this contemporary observational analysis of PE admissions undergoing CDI, there was an inverse association between hospital CDI volume and in-hospital mortality, LOS, and cost. Major bleeding and 30-day unplanned readmission rates were similar between the three groups.
Acceptance Date | Jun 22, 2022 |
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Publication Date | Jul 14, 2022 |
Journal | European Heart Journal Acute Cardiovascular Care |
Pages | 684 - 692 |
DOI | https://doi.org/10.1093/ehjacc/zuac082 |
Publisher URL | https://academic.oup.com/ehjacc/article-abstract/11/9/684/6643400?redirectedFrom=fulltext |
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