Abstract 13438: Resource Utilization and Outcome Trends of Intravascular Physiologic Testing During Percutaneous Coronary Intervention - United States National Inpatient Database Analysis 2014 Through 2019

Abstract

Introduction: Physiologic assessment of intermediate coronary stenosis has shown superiority in guiding decision making when compared to angiographic assessment alone. Many recent trials have shown improved outcomes using resting or hyperemic indices for severity assessment. In this study, we aimed to analyze the trends of intravascular physiologic testing during percutaneous coronary intervention (PCI), adjusted in-hospital mortality, adjusted in-hospital stay and adjusted hospital cost. Methods: Data were extracted from the National Inpatient Sample (NIS) 2014 through 2019 Database. The NIS was searched for PCI with and without intravascular physiologic testing in adult patients (age ≥18) using ICD 9 and 10 codes. Outcomes of interest were utilization rates of intravascular physiologic testing during PCI, trend of adjusted in-hospital mortality, adjusted mean LOS and adjusted mean hospital cost. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders. STATA software was used for analysis. Results: Of 2,871,865 PCIs in 2014 through 2019, 118,795 (4.1%) were coupled with intravascular physiologic testing. The use of intravascular physiologic testing during PCI steadily increased from 2.8% in 2014 to 5.0% in 2019 (trend p <0.001). The adjusted in-hospital mortality for PCI with physiologic testing did not show any significant statistical linear trend through the years (0.8% in 2014 vs. 0.9% in 2019, trend p=0.123). The mean adjusted LOS remained the same (3 days, trend p=0.530), whereas, mean adjusted hospital cost showed a linear trend of higher hospital cost (24033$ in 2014 vs. 25434$ in 2019, trend p=0.014). Conclusions: There is a rise in use of coronary intravascular physiologic testing during PCI. No statistically significant linear trend was observed in terms of in-hospital mortality or LOS for PCI with intravascular physiologic testing, however, over the years the mean hospital cost is on the rise.