U.S. Hospital Use of Echocardiography
Open accessAbstract
Background Increased use of echocardiography (echo) raises questions of whether echo is an overused diagnostic procedure in the United States.Objectives This study investigated national trends, practice patterns, and patient outcomes associated with inpatient echo use reported in the Nationwide Inpatient Sample (NIS).Methods We identified admission diagnoses most commonly associated with echo use and performed multivariate logistic regression within each diagnosis cohort to assess whether echo use was associated with all-cause inpatient mortality. Secondary analysis was performed within our institution to validate use trends identified in the NIS database.Results Between 2001 and 2011, the absolute volume and incidence of echo steadily increased at average annual rates of 3.41% and 3.04%, respectively. In 2010, the use of echo was associated with lower odds of inpatient mortality among hospitalizations for acute myocardial infarction (adjusted odds ratio [OR]: 0.74; 95% confidence interval [CI]: 0.63 to 0.86; p < 0.001), cardiac dysrhythmia (adjusted OR: 0.72; 95% CI: 0.55 to 0.94; p = 0.02), acute cerebrovascular disease (adjusted OR: 0.36; 95% CI: 0.31 to 0.42; p < 0.001), congestive heart failure (adjusted OR: 0.82; 95% CI: 0.72 to 0.94; p = 0.005), and sepsis (adjusted OR: 0.77; 95% CI: 0.70 to 0.85; p < 0.001). In 2010, these 5 diagnoses accounted for 3.7 million hospital admissions (9% of all hospitalizations); however, echo was reported in only 8% of cases. Secondary analysis of imaging practices at our institution confirmed underuse of echo among patients who died during hospitalization for indications identified in the NIS database.Conclusions Despite increasing rates of performance, echo may be underused during critical cardiovascular hospitalizations.
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The most common imaging modality in cardiovascular medicine is the cardiac ultrasound, or echocardiogram.
“The most common imaging modality in cardiovascular medicine is the cardiac ultrasound, or echocardiogram.”
From Deep learning-enabled medical computer vision (2021) · cites this paper as [65]
Echocardiography is uniquely suited for deep learning due to straightforward data acquisition and interpretation, and it is routinely used in most acute inpatient facilities, outpatient centers, and emergency rooms.
“As a cost-effective, radiation-free technique, echocardiography is uniquely suited for DL due to straightforward data acquisition and interpretation-it is routinely used in most acute inpatient facilities, outpatient centers, and emergency rooms 65 .”
From Deep learning-enabled medical computer vision (2021) · cites this paper as [65]
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- Authors
- Papolos, A., Narula, J., Bavishi, C., Chaudhry, F. A., & Sengupta, P. P.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- Corresponding author
- Sengupta, Partho P.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2016-02
- Volume
- 67
- Issue
- 5
- Pages
- 502-511
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2266692974
- Cited by
- 154
- References
- 17
- Citations by year
- 2026: 5 · 2025: 14 · 2024: 15 · 2023: 18 · 2022: 11 · 2021: 20 · 2020: 17 · 2019: 16 · 2018: 14 · 2017: 15 · 2016: 9
- FWCI
- 33.59
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Edwards Lifesciences
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Ultrasound in Clinical Applications
- Keywords
- echocardiography, unnecessary testing, in-hospital mortality, acute myocardial infarction, cardiac arrhythmias, acute cerebrovascular disease, congestive heart failure, sepsis, hospitalization trends
- MeSH terms
- Cardiovascular Diseases, Critical Care, Echocardiography, Female, Health Services Misuse, Hospitalization, Humans, Male, Middle Aged, United States, Hospital Mortality, Outcome Assessment, Health Care, Critical Pathways, Quality Improvement
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