Abstract Details

Title Impact of doing Echocardiogram and Brain Magnetic Resonance Imaging on Length of Stay and Hospital Charges in Transient Ischemic Attack Patients in United States: Analysis of Nationwide Inpatient Sample 2006-2014

Topic Practice, Policy, and Ethics

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-061

Objective To evaluate the impact of doing echocardiogram (ECHO) and brain magnetic resonance imaging (MRI) on length of stay (LOS) and hospital charges in transient ischemic attack (TIA) patients.

Background ECHO and brain MRI are often done as a part of work up in TIA patients. The impact of doing ECHO and MRI on LOS and hospital charges in TIA patients has not been well described before.

Design/Methods TIA patients from Nationwide Inpatient Sample database for years 2006-2014 were identified using the ICD 9 code (435). We compared LOS and hospital charges in TIA patients getting ECHO only, MRI only, both ECHO and MRI, with the control group of neither ECHO nor MRI. Prolonged length of stay (PLOS) is defined as greater than 2 days of hospital stay. In multivariate analysis PLOS was adjusted with age, gender, significant medical co-morbidities, in-hospital complications, and APRDRG_Severity.

Results Of 1,577,367 patients with TIA, 98914 (6.3%) patients got only ECHO, 67398 (4.3%) got only MRI, 25732 (1.63%) got both ECHO and MRI and 1385323 (87.8%) did not get neither ECHO nor MRI. In univariate analysis, the mean LOS (p= <.0001) and mean hospital charges (p= <.0001) were significantly higher in TIA patients getting ECHO only, MRI only, both ECHO and MRI, when compared to the control group. In multivariate analysis the PLOS was statistically significant in ECHO only (OR: 1.18, CI: 1.15-1.21, p=<.0001), MRI only (OR: 1.16, CI: 1.10-1.22, p=<.0001), and both ECHO and MRI groups (OR: 1.88, CI: 1.55-2.28, p=<.0001), when compared to control group.

Conclusions

LOS and hospital charges were significantly higher in TIA patients getting either ECHO or MRI or both. An important question is whether those tests impact treatment or prevention strategies to justify their performance. Further studies are needed to establish the role of ECHO and MRI on therapy as to justify their cost.

Authors/Disclosures
Harathi Bandaru, MD PRESENTER	Dr. Bandaru has nothing to disclose.
Mohammad Rauf A. Chaudhry, MD	Dr. Chaudhry has nothing to disclose.
Huy Q. Nguyen, MD	No disclosure on file
	No disclosure on file
Darine Kassar, MD	Dr. Kassar has nothing to disclose.
Rakesh Khatri, MD, FAAN	Dr. Khatri has received personal compensation in the range of $0-$499 for serving as a Survey consultant with Alpha insight . Dr. Khatri has received personal compensation in the range of $0-$499 for serving as a Survey consultant with Survey company .
Alberto Maud, MD (Paul L. Foster School of Medicine Texas Tech UHSC El Paso, Texas)	Dr. Maud has nothing to disclose.
	No disclosure on file
Paisith Piriyawat, MD (Texas Tech University)	Dr. Piriyawat has nothing to disclose.
Salvador Cruz-Flores, MD, FAAN (Paul L. Foster School of Medicine Texas Tech University Health Sciences Center)	The institution of Dr. Cruz-Flores has received research support from University of Texas System.

��ɫ��

��ɫ��