30% of Peripheral Vascular Disorders in Texas Hospitals involve Major Complications; Fort Worth Case Study


In Heart Failure

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By: James Pitt  Aug. 15, 2018

Peripheral artery disease (PAD) is a common condition in which narrowed blood vessels reduce blood flow to the limbs. Calcium buildups on the vessel walls frequently complicate treatment. Rocha-Singh et. al write “The prevalence of VC [vascular calcification] in lower extremity PAD is inadequately defined, but data extrapolated from other vascular beds provide evidence that 30-50% of patients may manifest some degree of VC.”

A variety of atherectomy devices can cut away calcium on vessel walls, but their safety is poorly understood. A recent approach is the Shockwave Medical Lithoplasty System, an endovascular catheter that uses ultrasound pulses to break up calcium deposits. This approach is intended to minimize complications and vessel injury.

The FDA cleared the device for sale under substantial equivalence, and a trial to compare the Lithoplasty System against standard balloon angioplasty is ongoing.

To estimate the burden of complications in PAD, Dexur analysts examined the case mix of peripheral vascular disorders, a slightly broader category, at 77 hospitals in Texas. On average, 30% of patients with peripheral vascular disorders had major complications, 49% had non-major complications, and 21% had no complications.

Case Mix of Peripheral Vascular Disorders, Texas Hospitals

Fort Worth is a useful representative example:

Peripheral Vascular Disease, Fort Worth Hospitals

Plaza Medical CenterBaylor Scott & White All SaintsTexas Health Harris MethodistTexas Health Harris Methodist Southwest
% major complications22.10%22.80%23.60%34.10%
% complications51.90%64.00%51.40%46.30%
% no complications26.00%13.20%25.00%19.60%

In Fort Worth, the highest proportion of PVD discharges with complications was at Plaza Medical Center, where 26% of PVD discharges had no complications. The highest proportion of non-major complications was 64%, at Baylor Scott & White All Saints Medical Center; and the highest proportion of major complications was 34.1%, at Texas Health Harris Methodist Southwest. Therefore, of these Fort Worth hospitals, Texas Health Harris Methodist Southwest and Baylor Scott & White All Saints may have the most demand for a solution that reduces complications in PVD.

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  1. Total DRG Discharges
  2. Total Heart Failure Discharges at DRG
  3. % of Heart Failure Discharges at DRG
  4. State % of Heart Failure Discharges at DRG
  5. National % of Heart Failure Discharges at DRG

For diagnosis-related groups DRG 299, DRG 300, and DRG 301, at the following hospitals:

  1. Baylor Scott & White All Saints Medical Center (Fort Worth, TX)
  2. Plaza Medical Center of Fort Worth (Fort Worth, TX)
  3. Texas Health Harris Methodist Hospital Southwest Fort Worth (Fort Worth, TX)
  4. Texas Health Harris Methodist Fort Worth (Fort Worth, TX)

And

  1. DRG 299 discharges
  2. DRG 300 discharges
  3. DRG 301 discharges
  4. % DRG 299
  5. % DRG 300
  6. % DRG 301

For all hospitals that reported 11 or more Medicare-eligible inpatient discharges in all three PVD DRGs, in the following Texas cities:

  1. Abilene
  2. Arlington
  3. Austin
  4. Baytown
  5. Beaumont
  6. Bedford
  7. Bryan
  8. Burleson
  9. Conroe
  10. Corpus Christi
  11. Cypress
  12. Dallas
  13. Denison
  14. Denton
  15. Edinburg
  16. El Paso
  17. Fort Worth
  18. Galveston
  19. Garland
  20. Grapevine
  21. Greenville
  22. Harlingen
  23. Houston
  24. Irving
  25. Kerrville
  26. Kingwood
  27. Laredo
  28. Longview
  29. Lubbock
  30. Lufkin
  31. Mcallen
  32. Mckinney
  33. Midland
  34. Paris
  35. Pasadena
  36. Plano
  37. Port Arthur
  38. San Angelo
  39. San Antonio
  40. Sugar Land
  41. Temple
  42. Texarkana
  43. The Woodlands
  44. Tomball
  45. Tyler
  46. Victoria
  47. Waco
  48. Webster
  49. Wichita Falls

ABOUT THE AUTHOR

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James Pitt

James Pitt is a science writer with experience in medical devices and textbook publishing. His hobbies include reading, flintknapping, and squinting at RStudio. He received a bachelor's in Human Evolutionary Biology from Harvard.