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Determinants of fluoroscopy time for invasive coronary angiography and percutaneous coronary intervention: Insights from the NCDR ®
dc.contributor.authorFazel, Rezaen_US
dc.contributor.authorCurtis, Jepthaen_US
dc.contributor.authorWang, Yongfeien_US
dc.contributor.authorEinstein, Andrew J.en_US
dc.contributor.authorSmith‐bindman, Rebeccaen_US
dc.contributor.authorTsai, Thomas T.en_US
dc.contributor.authorChen, Jerseyen_US
dc.contributor.authorShah, Nilay D.en_US
dc.contributor.authorKrumholz, Harlan M.en_US
dc.contributor.authorNallamothu, Brahmajee K.en_US
dc.date.accessioned2013-12-04T18:58:01Z
dc.date.available2015-01-05T13:54:43Zen_US
dc.date.issued2013-12-01en_US
dc.identifier.citationFazel, Reza; Curtis, Jeptha; Wang, Yongfei; Einstein, Andrew J.; Smith‐bindman, Rebecca ; Tsai, Thomas T.; Chen, Jersey; Shah, Nilay D.; Krumholz, Harlan M.; Nallamothu, Brahmajee K. (2013). "Determinants of fluoroscopy time for invasive coronary angiography and percutaneous coronary intervention: Insights from the NCDR ® ." Catheterization and Cardiovascular Interventions 82(7): 1091-1105.en_US
dc.identifier.issn1522-1946en_US
dc.identifier.issn1522-726Xen_US
dc.identifier.urihttps://hdl.handle.net/2027.42/101860
dc.description.abstractObjectives Identifying the distributions and determinants of fluoroscopy time for invasive coronary angiography (ICA) and percutaneous coronary intervention (PCI). Background ICA and PCI are significant contributors to radiation exposure from medical imaging in the US. Fluoroscopy time is a potentially modifiable determinant of radiation exposure for these procedures, but has not been well characterized in contemporary practice. Methods We evaluated the distribution of fluoroscopy time in patients undergoing ICA and/or PCI in the CathPCI Registry ® , stratifying patients by numerous clinical scenarios. Hierarchical models were used to determine patient, procedure, operator and hospital‐level factors associated with fluoroscopy time for these procedures. Results Our study included a total of 3,295,348 ICA and PCI procedures performed by 9,600 operators from January 2005 through June 2009. There was wide variation in fluoroscopy times for these procedures with median [IQR] fluoroscopy times of 2.6 [1.7–4.5] minutes for ICA, 6.7 [4.2–10.8] minutes for ICA in patients with prior coronary artery bypass grafting (CABG), 10.1 [6.0–17.4] minutes for PCI, 10.7 [7.0–16.9] minutes for PCI with ICA, and 16.0 [10.6–24.0] minutes for PCI and ICA in patients with prior CABG. Prolonged fluoroscopy times (>30 minutes) were rare for ICA, but occurred in 6.7% of PCIs and 14.7% of PCIs in patients with prior CABG. After accounting for patient characteristics and procedure complexity, operator and hospital‐level factors explained nearly 20% of the variation in fluoroscopy time. Conclusions Fluoroscopy times vary widely during ICA and PCI with operator and hospital‐level factors contributing substantially to these differences. A better understanding of potentially modifiable sources of this variation will elucidate opportunities for enhancing the radiation safety of these procedures. © 2013 Wiley Periodicals, Inc.en_US
dc.publisherNational Council on Radiation Protection and Measurementsen_US
dc.publisherWiley Periodicals, Inc.en_US
dc.subject.otherRDA—Radiation Physicsen_US
dc.subject.otherCATH—Diagnostic Cardiac Catheterizationen_US
dc.subject.otherPCI—Percutaneous Coronary Interventionen_US
dc.titleDeterminants of fluoroscopy time for invasive coronary angiography and percutaneous coronary intervention: Insights from the NCDR ®en_US
dc.typeArticleen_US
dc.rights.robotsIndexNoFollowen_US
dc.subject.hlbsecondlevelMedicine (General)en_US
dc.subject.hlbtoplevelHealth Sciencesen_US
dc.description.peerreviewedPeer Revieweden_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/101860/1/ccd24996.pdf
dc.identifier.doi10.1002/ccd.24996en_US
dc.identifier.sourceCatheterization and Cardiovascular Interventionsen_US
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dc.owningcollnameInterdisciplinary and Peer-Reviewed


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