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Intravascular Ultrasound in Lower Extremity Peripheral Vascular Interventions: Variation in Utilization and Impact on In-Hospital Outcomes From the Nationwide Inpatient Sample (2006-2011).
- Source :
- Journal of Endovascular Therapy; Feb2016, Vol. 23 Issue 1, p65-75, 11p, 1 Diagram, 6 Charts, 1 Graph
- Publication Year :
- 2016
-
Abstract
- <bold>Purpose: </bold>To examine the impact of intravascular ultrasound (IVUS) utilization during lower limb endovascular interventions as regards postprocedural complications and amputation.<bold>Methods: </bold>The study cohort was derived from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database between the years 2006 and 2011. Peripheral endovascular interventions were identified using appropriate ICD-9 procedure codes. Two-level hierarchical multivariate mixed models were created. The co-primary outcomes were in-hospital mortality and amputation; the secondary outcome was postprocedural complications. Model results are given as the odds ratio (OR) and 95% confidence interval (CI). Hospitalization costs were also assessed.<bold>Results: </bold>Overall, among the 92,714 patients extracted from the database during the observation period, IVUS was used in 1299 (1.4%) patients. IVUS utilization during lower extremity peripheral vascular procedures was independently predictive of a lower rate of postprocedural complications (OR 0.80, 95% CI 0.66 to 0.99, p=0.037) as well as lower amputation rates (OR 0.59, 95% CI 0.45 to 0.77, p<0.001) without any significant impact on in-hospital mortality. Multivariate analysis also revealed IVUS utilization to be predictive of a nonsignificant increase in hospitalization costs ($1333, 95% CI -$167 to +$2833, p=0.082).<bold>Conclusion: </bold>IVUS use during lower limb endovascular interventions is predictive of lower postprocedural complication and amputation rates with a nonsignificant increase in hospitalization costs. [ABSTRACT FROM AUTHOR]
- Subjects :
- INTRAVASCULAR ultrasonography
ANGIOPLASTY
AMPUTATION
PERIPHERAL vascular disease treatment
CHI-squared test
COST effectiveness
DATABASES
HOSPITAL costs
LEG
LIMB salvage
MULTIVARIATE analysis
PERIPHERAL vascular diseases
REGRESSION analysis
TIME
ULTRASONIC imaging
TREATMENT effectiveness
HOSPITAL mortality
ODDS ratio
ECONOMICS
Subjects
Details
- Language :
- English
- ISSN :
- 15266028
- Volume :
- 23
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Journal of Endovascular Therapy
- Publication Type :
- Academic Journal
- Accession number :
- 112798600
- Full Text :
- https://doi.org/10.1177/1526602815620780