title: Nonvascular Interventional Procedures in an Urban General Hospital: Analysis of 2001-2010 with Comparison to the Previous Decade.
abstract: OBJECTIVE
  To determine trends in nonvascular image-guided procedures at an urban general hospital over a 10-year period and to compare utilization of nonvascular interventional radiology (IR) over the decade 2001-2010 to a previously reported analysis for 1991-2000.
  
  
  METHODS
  With institutional review board approval, a 20-year quality assurance database verified against the radiology information system was queried for procedure location (eg, pleura, liver, bowel, and abdomen) and type (eg, biopsy, catheter insertion, and transient drainage), demographics, and change over time. Yearly admissions and new hospital numbers assigned each year served to normalize for overall hospital activity.
  
  
  RESULTS
  A total of 50,195 IR procedures were performed in 24,309 distinct patients (male:female, 12,625:11,684; average age, 60 years), 940 procedures performed in age <20 years, and 571 procedures performed in patients aged ≥90 years. A total of 15345, 4377, and 1754 patients had one, two, or three procedures, respectively; 470 had ≥10 procedures. Twenty-seven supervising radiologists and 277 individuals participated as operators, double the previous decade. Biopsy (4.8% average yearly increase), abdominal drainage (7.3%), paracentesis (12.9%), tube manipulation (13.0%), suprapubic bladder tube insertion (21.0%), and gastrostomy (44.6%) all increased strongly (P < .001) over 120 months but not biliary drainage, nephrostomy, or chest tubes. Procedures increased faster than either admissions or new hospital numbers (P < .001). For each 1000 new hospital numbers, IR service performed 48 procedures versus 31 the previous decade (P < .0005).
  
  
  CONCLUSIONS
  Referrals for nonvascular IR procedures have doubled over 2 decades, outpacing growth in new hospital patients and requiring increased resource allocation.
authors.affiliation: Department of Radiology, Massachusetts General Hospital and Harvard Medical School, White 220, 55 Fruit Street, Boston, MA, 02114. Electronic address: phahn@partners.org.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Hahn
authors.affiliation: Department of Radiology, Massachusetts General Hospital and Harvard Medical School, White 220, 55 Fruit Street, Boston, MA, 02114.
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Guimaraes
authors.affiliation: Department of Radiology, Massachusetts General Hospital and Harvard Medical School, White 220, 55 Fruit Street, Boston, MA, 02114.
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Arellano
authors.affiliation: Department of Radiology, Massachusetts General Hospital and Harvard Medical School, White 220, 55 Fruit Street, Boston, MA, 02114.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Mueller
authors.affiliation: Department of Radiology, Massachusetts General Hospital and Harvard Medical School, White 220, 55 Fruit Street, Boston, MA, 02114.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Gervais
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001900:Boston / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006769:Hospitals, General / Q000706:statistics & numerical data* / Q000639:trends*; D006786:Hospitals, Urban / Q000706:statistics & numerical data* / Q000639:trends*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000706:statistics & numerical data* / Q000639:trends*; D017678:Sex Distribution; D014600:Utilization Review; D014656:Vascular Surgical Procedures; D055815:Young Adult
keywords: Radiology; abdominal abscess; image-guided biopsy; interventional; utilization