Evaluation of the charges, safety, and mortality of percutaneous renal thermal ablation using the nationwide inpatient sample

Brian T. Welch, Waleed Brinjikji, Grant D. Schmit, A. Nicholas Kurup, Abdulrahman M. El-Sayed, Harry J. Cloft, R. Houston Thompson, Matthew R Callstrom, Thomas D. Atwell

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Purpose: To perform a national analysis of safety, charges, complications, and mortality of percutaneous image-guided renal thermal ablation and compare outcomes by hospital volume. Materials and Methods: Using the Nationwide Inpatient Sample, trends in the proportion of inpatient percutaneous renal thermal ablation procedures performed at high-volume centers in the United States from 2007-2011 were evaluated. In-hospital mortality, discharge to long-term care facility, length of stay, hospitalization charges, and postoperative complications were compared between high-volume and low-volume ablation centers. High volume was set at the 90th percentile for renal thermal ablation volume, which equated to seven or more patients per year. A multivariate logistic regression analysis adjusting for hospital volume, age, sex, Charlson Comorbidity Index, obesity, race, and insurance status was performed to analyze the influence of hospital volume on the above-listed outcomes. Results: This study included 874 patients. The number of hospitals ranged from 59-77 depending on year. Overall, 328 patients (37.5%) were treated at high-volume ablation centers. The proportion of patients treated at high-volume centers decreased from 42.0% in 2007-2009 to 28.5% in 2010-2011. High-volume hospitals also performed significantly more partial nephrectomies than low-volume hospitals. On multivariate logistic regression analysis, increasing hospital volume was associated with lower odds of in-hospital mortality (odds ratio [OR] = 0.31, 95% confidence interval [CI] = 0.02-0.95) and lower odds of discharge to a long-term care facility (OR = 0.00, 95% CI = 0.00-0.66). Increasing hospital volume was also associated with lower odds of blood transfusion (OR = 0.84, 95% CI = 0.72-0.94). Length of stay decreased with increasing hospital volume (P = .03). Conclusions: Patient safety may be maximized when renal ablation is performed at high-volume centers as a result of both greater procedural experience and potentially multidisciplinary triage and periprocedural management.

Original languageEnglish (US)
Pages (from-to)342-347
Number of pages6
JournalJournal of Vascular and Interventional Radiology
Volume26
Issue number3
DOIs
StatePublished - 2015

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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