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Impact of Contrast Echocardiography on Outcomes in Critically Ill Patients.

Publication ,  Journal Article
Main, ML; Fu, JW; Gundrum, J; LaPointe, NA; Gillam, LD; Mulvagh, SL
Published in: Am J Cardiol
July 1, 2021

Limited data suggests ultrasound enhancing agent (UEA) use is associated with changes in clinical management and lower mortality in intensive care unit (ICU) patients. We conducted a retrospective observational study to determine if contrast echocardiography (vs non-contrast echocardiography) is associated with differences in length of stay (LOS) and subsequent resource utilization in the ICU setting. The Premier Healthcare Database (Charlotte, NC) was analyzed to identify patients receiving Definity vs. no use of contrast during the initial rest transthoracic echocardiogram (TTE) in an ICU setting. The primary outcomes of interest were subsequent TTE and transesophageal echocardiography (TEE) during the index hospitalization, and ICU LOS. Propensity scoring was used to statistically model treatment selection to minimize selection bias. A total of 1,538,864 patients from 773 hospitals were identified as undergoing resting TTE in the ICU with use of DEFINITY in 51,141 (3.3%) patients and no contrast agent use in 1,487,723 (96.7%) patients. After adjusting for patient, clinical, and hospital characteristics, patients in the Definity cohort were less likely to undergo a subsequent TTE or TEE as compared to those in the no contrast cohort (odds ratio = 0.704 for TTE, odds ratio = 0.841 for TEE; p < 0.0001 for both). Adjusted mean ICU LOS for the Definity cohort was shorter than that of the no contrast cohort (4.59 vs 4.15 days, p < 0.0001). In conclusion, Definity-enhanced echocardiography in the ICU setting (in comparison with non-contrast TTE) is associated with lower rates of subsequent TTE and TEE during the index hospitalization, and shorter ICU LOS.

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Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

July 1, 2021

Volume

150

Start / End Page

117 / 122

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Propensity Score
  • Middle Aged
  • Male
  • Length of Stay
  • Intensive Care Units
  • Humans
  • Fluorocarbons
  • Female
 

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Main, M. L., Fu, J. W., Gundrum, J., LaPointe, N. A., Gillam, L. D., & Mulvagh, S. L. (2021). Impact of Contrast Echocardiography on Outcomes in Critically Ill Patients. Am J Cardiol, 150, 117–122. https://doi.org/10.1016/j.amjcard.2021.03.039
Main, Michael L., Julia Weleski Fu, Jake Gundrum, Nancy Allen LaPointe, Linda D. Gillam, and Sharon L. Mulvagh. “Impact of Contrast Echocardiography on Outcomes in Critically Ill Patients.Am J Cardiol 150 (July 1, 2021): 117–22. https://doi.org/10.1016/j.amjcard.2021.03.039.
Main ML, Fu JW, Gundrum J, LaPointe NA, Gillam LD, Mulvagh SL. Impact of Contrast Echocardiography on Outcomes in Critically Ill Patients. Am J Cardiol. 2021 Jul 1;150:117–22.
Main, Michael L., et al. “Impact of Contrast Echocardiography on Outcomes in Critically Ill Patients.Am J Cardiol, vol. 150, July 2021, pp. 117–22. Pubmed, doi:10.1016/j.amjcard.2021.03.039.
Main ML, Fu JW, Gundrum J, LaPointe NA, Gillam LD, Mulvagh SL. Impact of Contrast Echocardiography on Outcomes in Critically Ill Patients. Am J Cardiol. 2021 Jul 1;150:117–122.
Journal cover image

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

July 1, 2021

Volume

150

Start / End Page

117 / 122

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Propensity Score
  • Middle Aged
  • Male
  • Length of Stay
  • Intensive Care Units
  • Humans
  • Fluorocarbons
  • Female