Citations 2
Response to Letter Regarding Article “Impact of Annual Operator and Institutional Volume on Percutaneous Coronary Intervention Outcomes: A 5-Year United States Experience (2005–2009)”
Badheka, Apurva O., Patel, Nileshkumar, Grover, Peeyush , Singh, Vikas , Patel, Nilay , Arora, Shilpkumar , Chothani, Ankit , Mehta, Kathan , Deshmukh, Abhishek , Savani, Ghanshyambhai T., Patel, Achint , Panaich, Sidakpal , Shah, Neeraj , Brown, Michael, Mohamad, Tamam , Makkar, Raj , Schreiber, Theodore , Rihal, Charanjit S. , Cohen, Mauricio G. , Rathod, Ankit D. , Grines, Cindy L. , Rihal, Charanjit S. , Panaich, Sidakpal S , Cohen, Mauricio G
Circulation | August 3, 2015 | Volume: 132 | Issue: 5 | Pages: No page available
Influence of hospital volume on outcomes of percutaneous atrial septal defect and patent foramen ovale closure: A 10‐years us perspective
Singh, Vikas , Badheka, Apurva O., Patel, Nileshkumar, Chothani, Ankit , Mehta, Kathan , Arora, Shilpkumar , Patel, Nilay , Deshmukh, Abhishek , Shah, Neeraj , Savani, Ghanshyambhai T., Manvar, Sohilkumar, Thakkar, Badal, Panchal, Vinaykumar , Palacios, Igor F. , Rihal, Charanjit S. , Cohen, Mauricio G. , Marchena, Eduardo de , Rathod, Ankit D. , Patel, Jay N. , Rihal, Charanjit S. , O’Neill, William W. , Cohen, Mauricio G
Catheterization and Cardiovascular Interventions | December 22, 2014 | Volume: 85 | Issue: 6 | Pages: 1073-1081
Background: Contemporary data regarding percutaneous closure of atrial septal defect/patent foramen ovale (ASD/PFO) are lacking. We evaluated the current trends in utilization of ASD/PFO closure in adults and investigated the effect of annual hospital volume on in‐hospital outcomes. Methods: We queried the Nationwide Inpatient Sample between the years 2001 and 2010 using the International Classification of Diseases (ICD‐9‐CM) procedure code for percutaneous closure of ASD/PFO with device. Hierarchical mixed effects models were generated to identify the independent multivariate predictors of outcomes. Results: A total of 7,107 percutaneous ASD/PFO closure procedures (weighted n = 34,992) were available for analysis. A 4.7‐fold increase in the utilization of this procedure from 3/million in 2001 to 14/million adults in 2010 in US (P < 0.001) was noted. Overall, percutaneous ASD/PFO closure was associated with 0.5% mortality and 12% in‐hospital complications. The utilization of intracardiac echocardiography (ICE) increased 15 fold (P < 0.001) during the study period. The procedures performed at the high volume hospitals [2nd (14–37 procedures/year) and 3rd (>38 procedures/year) tertile] were associated with significant reduction in complications, length of stay and cost of hospitalization when compared to those performed at lowest volume centers (<13 procedures/year). Majority (70.5%) of the studied hospitals were found to be performing <10 procedures/year hence deviating from the ACC/AHA/SCAI clinical competency guidelines. Conclusions: Low hospital volume is associated with an increased composite (mortality and procedural complications) adverse outcome following ASD/PFO closure. In the interest of patient safety, implementation of the current guidelines for minimum required annual hospital volume to improve clinical outcomes is warranted. © 2014 Wiley Periodicals, Inc.