Health Care Utilization Following Inpatient Femoropopliteal Revascularization With Drug-Coated Balloon Angioplasty: A Nationwide Cohort Analysis.

Autor:	Gurin MI; Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA., Beyer SE; Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA., Weinberg M; Division of Cardiology, Department of Medicine, Northwell Health, New York, NY, USA., Parikh SA; Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA., Armstrong EJ; UCHealth Heart and Vascular Center, Aurora, CO, USA., Albaghdadi MS; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA., Aronow HD; Lifespan Cardiovascular Institute, Rhode Island and The Miriam Hospitals, Providence, RI, USA., Carroll BJ; Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA., Yeh R; Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA., Secemsky EA; Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.; Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology at Beth Israel Deaconess Medical Center, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists [J Endovasc Ther] 2021 Apr; Vol. 28 (2), pp. 246-254. Date of Electronic Publication: 2021 Jan 11.
DOI:	10.1177/1526602820984111
Abstrakt:	Purpose: To examine nationwide variations in inpatient use of drug-coated balloons (DCBs) for treating femoropopliteal segment occlusive disease and whether DCBs are associated with reduced early out-of-hospital health care utilization. Materials and Methods: The study included 24,022 patients who survived hospitalization for femoropopliteal revascularization using DCB angioplasty (n=7850) or uncoated balloon angioplasty (n=16,172) in the 2016-2017 Nationwide Readmissions Database. Differences in patient, hospitalization, and institutional characteristics were compared between treatment strategies. Adjusted logistic regression models were used to examine differences in 6-month rates of readmission, amputation, and repeat intervention. Results are presented as the odds ratio (OR) and 95% confidence interval (CI). Results: Patients treated with DCBs had a higher prevalence of chronic limb-threatening ischemia, diabetes, hypertension, and tobacco use. Revascularization with a DCB was associated with shorter hospitalizations, lower median hospitalization costs, and fewer inpatient lower extremity amputations. Readmissions at 6 months were decreased in patients treated with DCBs compared with uncoated balloon angioplasty (OR 0.90, 95% CI 0.83 to 0.98, p=0.014). The most common reasons for readmission were complications related to procedures (15.4%) and diabetes (15.4%). Compared to patients treated with DCBs, patients treated with uncoated balloon angioplasty were more often readmitted with early procedure-related complications (13.3% vs 17.5%). There were no between-group differences in readmission for sepsis, myocardial infarction, or congestive heart failure. Conclusion: DCBs are less often used compared to uncoated balloons during inpatient femoropopliteal procedures. While DCB utilization is associated with more severe comorbidities and advanced peripheral artery disease, readmission rates are decreased through the first 6 months.
Databáze:	MEDLINE
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