Abstract 10545: Hospital Teaching Status Increases the Frequency of Measurement of Right Heart Pressures in Patients Hospitalized for Heart Failure: A Nationwide Analysis

Abstract

Introduction: Measurement of right heart pressures is a useful, yet non-routine diagnostic tool whose indications in heart failure are not standardized. In this study, we investigated teaching status as an independent predictor of measurement of right heart pressures. Methods: This was a retrospective cohort study using the 2018 Nationwide Inpatient Sample that included adult patients with a primary diagnosis of heart failure that were admitted to urban hospitals. Rural hospitals were excluded. The primary outcome was measurement of right heart pressures. Secondary outcomes included performance of coronary angiogram, length of stay, total hospitalization charges. Multiple regression analysis was used to adjust for hospital bed size, region, and type of ownership, as well as the patient’s age, type of insurance, income quartile, Charlson Comorbidity Index, chronic obstructive pulmonary disease, pulmonary hypertension, and other relevant comorbidities with a p-value <0.2 in univariate screen. Statistical analysis was performed using Stata 17.0. Results: A total of 1,117,134 (weighted) heart failure hospitalizations were studied, of which a total of 31,085 underwent measurement of right heart pressures. Multivariate regression analysis revealed that hospital teaching status was associated with a greater frequency of measurement of right heart pressures with an odd ratio (OR) 3.03 (95% CI, 2.38 to 3.89, p=0.000). The secondary outcomes of coronary angiogram, length of stay, and total hospitalization charges were also increased. Conclusions: Teaching status increases the frequency of measurement of right heart pressures in heart failure hospitalizations. This might highlight the need to standardize indications applicable across the spectrum of hospital settings.