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Impact of COVID-19 pandemic healthcare restrictions on utilisation and diagnostic yield of outpatient transthoracic echocardiograms

Published online by Cambridge University Press:  16 November 2022

Michael W. Scott Open the ORCID record for Michael W. Scott [Opens in a new window] ,
Christina Metcalf ,
Sagnik Bhadury ,
Yana Feygin  and
Ashley E. Neal
Michael W. Scott
Affiliation:
Department of Pediatrics, University of Louisville, Louisville, KY, USA
Christina Metcalf
Affiliation:
Department of Pediatrics, University of Louisville, Louisville, KY, USA
Sagnik Bhadury
Affiliation:
Department of Biostatistics, University of Louisville, Louisville, KY, USA
Yana Feygin
Affiliation:
Norton Children’s Research Institute Affiliated with University of Louisville School of Medicine, Louisville, KY, USA
Ashley E. Neal*
Affiliation:
Department of Pediatrics, University of Louisville, Louisville, KY, USA Norton Children’s, Louisville, KY, USA
*
Author for correspondence: Ashley E. Neal, MD, 3333 Burnet Ave, Cincinnati, OH 45229, USA.E-mail: ashley.neal2@cchmc.org
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Abstract

Background:

During the COVID-19 pandemic, Kentucky prohibited elective medical procedures from 3/18/2020-4/27/2020. We sought to determine if cessation of elective procedures in Kentucky during the COVID-19 pandemic resulted in a decrease in the proportion of rarely appropriate outpatient transthoracic echocardiograms interpreted at the open echocardiography lab at Norton Children’s Hospital.

Methods:

A retrospective chart review was conducted comparing proportions of rarely appropriate outpatient paediatric transthoracic echocardiograms performed pre-COVID (3/21/2019-4/28/2019) and during COVID (3/19/2020-4/27/2020). Transthoracic echocardiogram indication was determined by chart review and echocardiogram reports. Indication appropriateness was evaluated using paediatric appropriate use criteria for initial outpatient transthoracic echocardiogram or CHD follow-up as applicable.

Results:

Of transthoracic echocardiograms pre-COVID, 100 (37.7%) were rarely appropriate versus 18 (20.2%) during COVID. Pre-COVID, paediatric cardiologists tended to order fewer rarely appropriate transthoracic echocardiograms than paediatricians (35.9% versus 46.4%), although this difference was not statistically significant. Cardiologists ordered the majority of outpatient transthoracic echocardiograms during COVID (77/89, 86.5%), limiting the ability to compare transthoracic echocardiogram indications by provider type. There was no significant difference in diagnostic yield of initial outpatient transthoracic echocardiograms with (13.0%) abnormal studies pre-COVID versus 7 (15.5%) during COVID.

Conclusion:

While elective procedures were prohibited in Kentucky during the COVID-19 pandemic, a decrease in the proportion of rarely appropriate outpatient paediatric transthoracic echocardiograms was observed. There was no significant difference in diagnostic yield of initial outpatient transthoracic echocardiograms between time periods, suggesting that clinically significant echocardiogram findings were still detected despite more prudent utilisation of echocardiography during this time.

Keywords

Paediatriccardiologyechocardiogramappropriate use criteria
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 10 , October 2023 , pp. 1936 - 1941
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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