IMPACT OF TEACHING HOSPITAL STATUS ON OUTCOMES IN PATIENTS WITH PRIMARY DIAGNOSIS OF POSTPROCEDURAL PNEUMOTHORAX: A RETROSPECTIVE NATIONAL IN-PATIENT SAMPLE STUDY

TOPIC: Procedures TYPE: Original Investigations PURPOSE: Postprocedural pneumothorax (iatrogenic) is a patient safety indicator resulting from invasive procedures such as insertion of subclavian central line, pacemaker placement, trans-bronchial pulmonary biopsy and transthoracic biopsy. This study examines the impacts teaching hospital status on outcomes in patients admitted primarily for postprocedural pneumothorax. METHODS: Cohort aged 18 or older who had primary diagnosis post-procedural were identified National Inpatient Sample (NIS) database years 2016 to 2017 using ICD 10-diagnosis code. The population was divided into two groups – (TH) vs non-teaching (NTH). Demographics, baseline co-morbidities, clinical events compared between groups. Primary outcome interest in-hospital mortality. Secondary length stay total hospitalization charges. Statistical analyses performed chi-square student-t test. Odds ratio (OR) comparing both group estimated with logistic regression RESULTS: A 18,703 cases iatrogenic out 14 million (unweighted) admissions (131 per 100,000 encounter) incidence 144 encounters TH 103 NTH. Out identified, only 4375 diagnosis, these included analysis. patients, 2954 1421 Baseline characteristics including age (67.4 ± 12.6 68.6 ±11.7 NTH), female gender (52.7% 53% smoking history (63.8% 66.4% lung cancer (32.6% 33.7% active malignancy (49.4% 50.2% heart failure (9.7% 10.3% NTH) statistically not different There significant higher rates chronic disease NTH (49.5% 54.7% NTH, p = 0.001). Clinical hypotension (3.2 % 2.8%), subcutaneous emphysema (6.5% 6.9% cardiac arrest (0.37% 0.35%), needle chest decompression (4.0% 4.6% tube placement (78.8% 79.4% On outcomes, mortality rate 1.18% 1.26% (age adjusted OR 1.01, 95% CI 0.99 1.04, 0.17). measures showed significantly charges ($44,733 $68,841 $39,605 $51,309, 0.01) whereas (4.5 5.3 days 4.2 4.0 days, 0.08). CONCLUSIONS: Despite hospital, our no associated worse terms CLINICAL IMPLICATIONS: Our raises concern that physicians-in-training due lack experience may be major factor accounting DISCLOSURES: No relevant relationships by Sahai Donaldson, source=Web Response disclosure file Daniel Larbi; Alem Mehari, Richard Ogunti, Lamiaa Rougui,