Impact of chronic thrombocytopenia on healthcare resource utilization, in-hospital outcomes, and costs following percutaneous coronary intervention of chronic total occlusion: a nationwide propensity weighted analysis

Sheriff N Dodoo; Bettye A Apenteng; Alexis K Okoh; Isaac A Opoku; Ugochukwu O Egolum; Nima Ghasemzadeh; Ronnie Ramadan; Glen Henry; Gregory Giugliano

doi:10.62347/WSNS5966

Impact of chronic thrombocytopenia on healthcare resource utilization, in-hospital outcomes, and costs following percutaneous coronary intervention of chronic total occlusion: a nationwide propensity weighted analysis

Am J Cardiovasc Dis. 2024 Feb 20;14(1):9-20. doi: 10.62347/WSNS5966. eCollection 2024.

Authors

Sheriff N Dodoo¹, Bettye A Apenteng², Alexis K Okoh³, Isaac A Opoku⁴, Ugochukwu O Egolum⁵, Nima Ghasemzadeh⁶, Ronnie Ramadan⁶, Glen Henry⁶, Gregory Giugliano⁶

Affiliations

¹ Georgia Heart Institute, Northeast Georgia Medical Center 743 Spring Street NE, Gainesville, GA 30501, USA.
² Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University 501 Forest Dr, Statesboro, GA 30458, USA.
³ Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University School of Medicine 1462 Clifton Way NE, Atlanta, GA 30322, USA.
⁴ Department of Internal Medicine, Piedmont Athens Regional Hospital 1270 Prince Ave, Suite 102, Athens, GA 30606, USA.
⁵ Georgia Heart Institute, Northeast Georgia Medical Center 200 S Enota Dr NE Suite 100, Gainesville, GA 30501, USA.
⁶ Georgia Heart Institute, Northeast Georgia Medical Center 200 S Enota Dr NE Suite 200, Gainesville, GA 30501, USA.

Abstract

Background: Data on the impact of chronic thrombocytopenia (CT) on outcomes following chronic total occlusion (CTO) percutaneous coronary interventions (PCI) is limited. Most studies are case reports and focused on postprocedural thrombocytopenia. The purpose of this present study is to assess the impact of CT (> one year) on health resource utilization (HRU), in-hospital outcomes, and cost following CTO PCI.

Methods: We used discharge data from the 2016-2018 National Inpatient Sample and propensity score-weighted approach to examine the association between CT and HRU among patients undergoing CTO PCI. HRU was measured as a binary indicator defined as a length of stay greater than seven days and/or discharge to a non-home setting. The cost was measured as total charges standardized to 2018 dollars. Both outcomes were assessed using generalized linear models adjusted for survey year, and baseline characteristics.

Results: Relative to its absence, the presence of CT following CTO PCI was associated with a 4.8% increased probability of high HRU (Population Average Treatment Effect (PATE) estimate = 0.048; 95% Confidence Interval (CI) = 0.041-0.055; P<0.001) and approximately $18,000 more in total hospital charges (PATE estimate = +$18,297.98; 95% CI = $15,101.33-$21,494.63, P<0.001).

Conclusion: Among chronic total occlusion patients undergoing percutaneous coronary intervention, those with chronic thrombocytopenia had higher resource use, including total hospital charges, and worse in-hospital outcomes when compared with those without chronic thrombocytopenia.

Keywords: Chronic total occlusion; healthcare resource utilization; percutaneous coronary intervention.