Abstract 11167: Health Care Utilization of Adenosine-Sensitive Supraventricular Tachycardia Patients Presenting to the Emergency Department
INTRODUCTION: Although adenosine-sensitive supraventricular tachycardia (SVT) is generally curable with catheter ablation, it remains an important cause of health care utilization. We sought to determine the predictors of health care utilization among SVT patients presenting to the emergency department (ED).
METHODS: We performed a single center retrospective cohort study of consecutive patients seeking care for an adenosine-sensitive SVT in an urban ED between February 2006 and August 2011. Baseline covariates were assessed as predictors of ambulance usage and hospital admission for the index ED visit, while baseline and time-updated covariates were assessed as predictors of recurrent ED visits.
RESULTS: A total of 100 adenosine-sensitive SVT patients presenting for their first ED visit were included. After multivariable adjustment, each year increase in age was associated with a 5% greater odds of ambulance usage (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.02-1.09, p=0.001), while a prior visit to an electrophysiologist reduced the odds of ambulance usage by 87% (OR 0.13, 95% CI 0.025-0.69, p=0.016). A positive troponin was the only covariate associated with a significantly increased adjusted odds of admission (OR 22.7, 95% CI 1.94-265.5, p=0.013). In the time-updated analysis illicit drug use (hazard ratio [HR] 2.2, 95% CI 1.15-4.23, p=0.017) increased the risk of recurrent ED visits. Every 10 beat per minute increase in heart rate reduced the risk of recurrent ED visits by 8% (HR 0.92, 95% CI 0.87-0.98, p=0.009). Ablation reduced the risk of recurrent ED visits by 91% (HR 0.09, 95% CI 0.04-0.19, p <0.001, Figure 1 ).
CONCLUSION: Readily modifiable predictors, particularly a previous visit to an electrophysiologist and ablation for SVT, are associated with markedly reduced health care utilization among patients presenting to the ED with SVT.
- © 2013 by American Heart Association, Inc.