BACKGROUND: Increased use of echocardiography (echo) raises questions of whether echo is an overused diagnostic procedure in the United States. OBJECTIVES: This study investigated national trends, practice patterns, and patient outcomes associated with inpatient echo use reported in the Nationwide Inpatient Sample (NIS). METHODS: We identified admission diagnoses most commonly associated with echo use and performed multivariate logistic regression within each diagnosis cohort to assess whether echo use was associated with all-cause inpatient mortality. Secondary analysis was performed within our institution to validate use trends identified in the NIS database. RESULTS: Between 2001 and 2011, the absolute volume and incidence of echo steadily increased at average annual rates of 3.41% and 3.04%, respectively. In 2010, the use of echo was associated with lower odds of inpatient mortality among hospitalizations for acute myocardial infarction (adjusted odds ratio [OR]: 0.74; 95% confidence interval [CI]: 0.63 to 0.86; p < 0.001), cardiac dysrhythmia (adjusted OR: 0.72; 95% CI: 0.55 to 0.94; p = 0.02), acute cerebrovascular disease (adjusted OR: 0.36; 95% CI: 0.31 to 0.42; p < 0.001), congestive heart failure (adjusted OR: 0.82; 95% CI: 0.72 to 0.94; p = 0.005), and sepsis (adjusted OR: 0.77; 95% CI: 0.70 to 0.85; p < 0.001). In 2010, these 5 diagnoses accounted for 3.7 million hospital admissions (9% of all hospitalizations); however, echo was reported in only 8% of cases. Secondary analysis of imaging practices at our institution confirmed underuse of echo among patients who died during hospitalization for indications identified in the NIS database. CONCLUSIONS: Despite increasing rates of performance, echo may be underused during critical cardiovascular hospitalizations.
BACKGROUND: Increased use of echocardiography (echo) raises questions of whether echo is an overused diagnostic procedure in the United States. OBJECTIVES: This study investigated national trends, practice patterns, and patient outcomes associated with inpatient echo use reported in the Nationwide Inpatient Sample (NIS). METHODS: We identified admission diagnoses most commonly associated with echo use and performed multivariate logistic regression within each diagnosis cohort to assess whether echo use was associated with all-cause inpatient mortality. Secondary analysis was performed within our institution to validate use trends identified in the NIS database. RESULTS: Between 2001 and 2011, the absolute volume and incidence of echo steadily increased at average annual rates of 3.41% and 3.04%, respectively. In 2010, the use of echo was associated with lower odds of inpatient mortality among hospitalizations for acute myocardial infarction (adjusted odds ratio [OR]: 0.74; 95% confidence interval [CI]: 0.63 to 0.86; p < 0.001), cardiac dysrhythmia (adjusted OR: 0.72; 95% CI: 0.55 to 0.94; p = 0.02), acute cerebrovascular disease (adjusted OR: 0.36; 95% CI: 0.31 to 0.42; p < 0.001), congestive heart failure (adjusted OR: 0.82; 95% CI: 0.72 to 0.94; p = 0.005), and sepsis (adjusted OR: 0.77; 95% CI: 0.70 to 0.85; p < 0.001). In 2010, these 5 diagnoses accounted for 3.7 million hospital admissions (9% of all hospitalizations); however, echo was reported in only 8% of cases. Secondary analysis of imaging practices at our institution confirmed underuse of echo among patients who died during hospitalization for indications identified in the NIS database. CONCLUSIONS: Despite increasing rates of performance, echo may be underused during critical cardiovascular hospitalizations.
Authors: Varsha K Tanguturi; Michael K Hidrue; Michael H Picard; Steven J Atlas; Jeffrey B Weilburg; Timothy G Ferris; Katrina Armstrong; Jason H Wasfy Journal: Circ Cardiovasc Imaging Date: 2017-08 Impact factor: 7.792
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Authors: Jordan B Strom; Varsha K Tanguturi; Sherif F Nagueh; Allan L Klein; Warren J Manning Journal: J Am Soc Echocardiogr Date: 2019-09-25 Impact factor: 5.251
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Authors: Quinn R Pack; Aruna Priya; Tara C Lagu; Penelope S Pekow; Joshua P Schilling; William L Hiser; Peter K Lindenauer Journal: Circulation Date: 2018-04-17 Impact factor: 29.690
Authors: Daniel De Backer; Jan Bakker; Maurizio Cecconi; Ludhmila Hajjar; Da Wei Liu; Suzanna Lobo; Xavier Monnet; Andrea Morelli; Sheila Neinan Myatra; Azriel Perel; Michael R Pinsky; Bernd Saugel; Jean-Louis Teboul; Antoine Vieillard-Baron; Jean-Louis Vincent Journal: Intensive Care Med Date: 2018-05-03 Impact factor: 17.440