Document Detail


Economic and angiographic factors in determining optimal catheter size in performing outpatient left-sided heart and coronary angiography.
MedLine Citation:
PMID:  8602566     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A prospective randomized trial was performed in 300 patients to establish the optimal catheter size (5.2, 6, or 7Fr) in performing outpatient left heart and coronary arteriography. A secondary randomization was performed between an attending physician and cardiovascular fellow to determine if the experience level of the operator was an important factor when using smaller French-sized catheters. The primary end point of the trial was total resource utilization of the patient's hospitalization. Hospital cost was calculated with cost accounting methodology using a "bottom-up" approach, and physician "cost" was determined with the Resource-Based Relative Value Scale. Angiographic quality was graded with qualitative and quantitative methods. Procedures were faster and time to hemostasis shorter with smaller catheters. The more experienced operators performed faster procedures and used less fluoroscopy. In the cardiac catheterization laboratory, health-care personnel cost was higher with the 6Fr catheters and when the attending physician was the primary operator. Postprocedure care was slightly less expensive with the smaller catheters. Overall, there was no difference in total cost between the catheter sizes and primary operators. Angiographic quality was similar between the catheter sizes. Smaller catheters used in performing outpatient left-sided heart and coronary arteriography are not associated with cost savings but do not compromise angiographic quality.
Authors:
J D Talley; P D Mauldin; J Kupersmith
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  77     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1996 Feb 
Date Detail:
Created Date:  1996-05-03     Completed Date:  1996-05-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  374-8     Citation Subset:  AIM; IM    
Affiliation:
Section of Invasive and Interventional Cardiology, University of Louisville School of Medicine, Kentucky, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Clinical Competence
Coronary Angiography* / economics,  instrumentation
Female
Heart Catheterization / economics,  instrumentation*,  methods
Hospital Costs
Humans
Male
Middle Aged
Outpatient Clinics, Hospital / economics
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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