National Trend in utilization of pulmonary ventilation-perfusion scan in the United States 1993 - 2015

1482 Objectives: Pulmonary ventilation-perfusion (V/Q) scan was the first noninvasive procedure for diagnosis of pulmonary embolism (PE), introduced in 1964. Over time, pulmonary CT angiography (CTPA) has become the imaging modality of choice in imaging algorithm of suspected PE. Currently pulmonary V/Q scan is mainly performed in patients with contraindication for CTPA. This is the first study to depict the national trends in utilization of pulmonary V/Q scan in the United States from 1993 to 2015. Methods: The utilization of pulmonary V/Q scan in inpatient setting (1993- 2015) and in the emergency department (2006- 2014) were modeled over time. Data were obtained from the United States healthcare cost and utilization project (HCUPnet) databases. Inpatient discharge-level encounters and emergency department visits with pulmonary V/Q scan as one of the performed procedures were included. Total encounters, and adjusted rate of discharges/visits per 100,000 persons were used as the statistical metrics. Results: There is significant decrease in pulmonary V/Q scan utilization in an inpatient setting from 126,182 encounters in 1993 to 11,165 encounters in 2014 (Adjusted rate per 100,000 persons: 48.5 in 1993 to 3.0 in 2015). Trend analysis showed an estimated annual percentage change of - 9.9% (1993- 1998), - 22.4% (1998- 2002) and - 8.7% (2002-2015) in pulmonary V/Q scan utilization rate. Similar trend in pulmonary V/Q scan utilization was observed in the emergency department (2006- 2014), with 20,756 encounters in 2006 to 13,999 encounters in 2014, and respective adjusted rate of 7.0 and 4.4 visits per 100,000 persons in 2006 and 2014. Trend analysis showed an estimated annual percentage change of - 8.5% in utilization rate (2006- 2014). Conclusions: Pulmonary V/Q scan utilization has significantly decreased over the past two decades (1993- 2015) with the sharpest decline in utilization rate between 1998- 2002.