We examined length of stay (LOS), and cost of hospitalization (COST), in a large multicenter analysis of hospitalized patients undergoing clinically indicated stress echocardiography (SE) with and without use of an ultrasound contrast agent.
Retrospective analysis was performed using validated discharges included in a large outcomes database (Premier Healthcare Solutions, Charlotte, NC) during the interval from 2002-2009. Two propensity-matched cohorts were constructed: treatment cohort included patients who had SE with the perflutren lipid microsphere injectable contrast agent Definity®,(Lantheus Medical Imaging, N. Billerica, MA) while the control cohort included patients who had SE without use of contrast agent. Multivariate gamma regression was used to compare LOS, and COST after performance of SE.
26,716 patients were included (13,358 patients/cohort) representing data from 321 U.S. acute care hospitals. Baseline characteristics were comparable between contrast and non-contrast cohorts, Table. Contrast cohort showed a shorter LOS (3.3%, 95% confidence interval [CI] 0.948, 0.987; p=.002), and lower COST (-5.1%, CI 0.926, 0.976; p<.001) than the non-contrast cohort. Subgroup analysis by type of SE (exercise vs pharmacologic) demonstrated that patients undergoing contrast pharmacologic SE had significantly shorter (3.3%) LOS (95% CI 0.940, 0.996; p=.024), and 8% lower COST (95% CI 0.900, 0.958; p<.001), than non-contrast cohort. Patients undergoing contrast exercise SE had significantly shorter (4.1%) LOS (95% CI 0.933, 0.987; p=.004) but insignificantly (0.9%) lower COST (95% CI 0.955, 1.027; p=0.614).
Use of ultrasound contrast agents during stress echocardiography in hospitalized patients was associated with shorter lengths of stay and lower hospitalization costs.
© 2014 Published by Elsevier Inc.