Khera, RohanPandey, AmbarishKumar, NilaySingh, RajeevBano, ShahGolwala, HarshKumbhani, Dharam J.Girotra, SaketFonarow, Gregg C.2018-05-102018-05-102016-11Khera, R., Pandey, A., Kumar, N., Singh, R., Bano, S., Golwala, H., … Fonarow, G. C. (2016). Variation in Hospital-use and Outcomes Associated with Pulmonary Artery Catheterization in Heart Failure in the United States. Circulation. Heart Failure, 9(11). https://doi.org/10.1161/CIRCHEARTFAILURE.116.0032261941-3289https://hdl.handle.net/1805/16131Background There has been an increase in the use of pulmonary artery (PA) catheters in heart failure (HF) in the United States in recent years. However, patterns of hospital-use and trends in patient outcomes are not known. Methods and Results In the National Inpatient Sample 2001–2012, using ICD-9 codes we identified 11,888,525 adult (≥18 years) HF hospitalizations nationally, of which an estimated 75,209 (SE 0.6%) received a PA catheter. In 2001, the number of hospitals with ≥1 PA catheterization was 1753, decreasing to 1183 in 2011. The mean PA catheter use per hospital trended from 4.9/year in 2001 (limits 1–133) to 3.8/year in 2007 (limits 1–46), but increased to 5.5/year in 2011 (limits 1–70). During 2001–2006, PA catheterization declined across hospitals; however, in 2007–2012 there has been a disproportionate increase at hospitals with large bedsize, teaching programs, and advanced HF capabilities. The overall in-hospital mortality with PA catheter use was higher than without PA catheter use (13.1% vs. 3.4%, P<0.0001), however, in propensity-matched analysis, differences in mortality between these groups have attenuated over time – risk-adjusted odds ratio for mortality for PA-catheterization, 1.66 (95% CI 1.60–1.74) in 2001–2003 down to 1.04 (95% CI 0.97– 1.12) in 2010–2012. Conclusions There is substantial hospital-level variability in PA catheterization in HF along with increasing volume at fewer hospitals overrepresented by large, academic hospitals with advanced HF capabilities. This is accompanied by a decline in excess mortality associated with PA catheterization.Publisher PolicyInternational Classification of Diseasescatheterizationheart failurehospitalizationpulmonary arteryArticle