Abstract 11415: The Intermountain Risk Score Predicts Higher Healthcare Utilization and Cost in Atherosclerotic Cardiovascular Disease.

Background: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of mortality and healthcare expenditures. Annual indirect and direct costs of ASCVD are estimated to be $330 billion in the US. The Intermountain Mortality Risk Scores (IMRS) are practical parsimonious models that are highly predictive of death and other major adverse events. It is unknown if IMRS tools predict healthcare utilization and cost. Methods: Patients ≥18 years of age with a first encounter for ASCVD (CAD/MI, CVD, and PAD) between Jan 1, 1999 and Dec 31, 2013, and who survived index ASCVD event were studied. Sex-specific weightings of the comprehensive metabolic panel and complete blood count components were applied to calculate IMRS and patients were stratified into low, moderate, and high risk categories based on previously published thresholds. Results: nAmong females (n=9,150), age averaged 69±15 years, 53.6% had CAD, and 61.4%, 29.6%, and 9.0% were in the low, moderate, and high risk categories, respectively. Males (n=14,176) averaged 66±13 years, 71.1% had CAD, and 56.2%, 35.8%, and 8.0% were in the low moderate, and high risk categories, respectively. IMRS was highly predictive of gradients in 1 year death across low, moderate, and high risk categories (females: 4.8%, 16.8%, 32.6%, p<0.0001; males: 2.0%, 8.9%, and 25.9%, p<0.0001). The higher-risk categories were also associated with more PCIs and angiograms among both genders in the year after the index ASCVD event. Risk strata of IMRS predicted cost among those who did not die by 1 year, but not among those who died before 1 year (Figure). Conclusion: A practical parsimonious clinical decision tool, IMRS predicted higher utilization of angiograms and PCIs at 1 year, greater risk of death at 1 year, and higher costs among those who survived the first year. IMRS identified the higher-risk patients as to risk of death and healthcare utilization and cost. IMRS may be a useful new tool to predict and manage increasing costs. [ABSTRACT FROM AUTHOR]