Abstract
Background There is no direct evidence from the available literature on whether aneurysm mortality rates in hospitals decreases if they comply with American College of Radiologists' (ACR) guidelines on diagnostic imaging and treatment interventions. This study investigated on the possibility of increasing ACR compliance levels progressively reducing inhospital mortality rates of aneurysm patients.
Aims The study was aimed at examining whether the mortality rates of aortic aneurysm patients in hospital decrease if the hospitals comply with ACR guidelines on diagnostic imaging and treatment interventions. The second aim was to test the assumption that increasing compliance levels will progressively decrease the in-hospital mortality rate.
Methods Data on 36,104 net samples of patients collected from NIS data covering 47 US hospitals based on ICD-9 classification were collected for the period of 2008-2012. The collected data were analysed for effect of ACR compliance of imaging methods and a modified ACR appropriateness rating on mortality rates of six major types of aortic aneurysm patients. Pearson's Chi-Square test, Gamma Correlation test and Logistic Regression test were done using the latest version of SPSS software. A predictive probabilistic equation for odds relationship of ACR compliance with mortality rate was also developed.
Results A large majority of US hospitals did not fully or partially comply with ACR guidelines. Clear evidence of increasing compliance level with ACR guidelines on both imaging methods and appropriateness rating on reduction of inhospital mortality rates were obtained. There was negative relationship between compliance level and mortality rate. The relationship was linear and not affected by other predictors. This negative relationship reflected in the predictive equation. Therefore there is a strong case for hospitals implementing full compliance with ACR guidelines.
Conclusion The overall conclusion is that there is negative relationship between ACR compliance level and in-hospital mortality rate of aortic aneurysm patients. Increasing levels of ACR compliance progressively decreased in-hospital mortality rates, although this relationship may not be cause-effect relationship. Policies for implementing full ACR compliance by hospitals may reduce in-hospital mortality rate of aneurysm patients significantly.