Key result
Rising endomyocardial biopsy rates are linked to an ~8% reduction in major complications.
Why the study?
Data regarding temporal trends of total numbers, characteristics, in-hospital outcomes, and complications of patients undergoing endomyocardial biopsy were sparse.
How have the usage trends, patient characteristics, and complication rates of endomyocardial biopsy changed over time in Germany?
Observational (n=67,745)
Yes
How have the usage trends, patient characteristics, and complication rates of endomyocardial biopsy changed over time in Germany?
The annual number of endomyocardial biopsies in Germany increased significantly from 2005 to 2019, and despite patients being older and more comorbid, major complications decreased, underscoring the procedure's safety.
Answers are grounded in this paper and cite their sources.
Rising EMB use in Germany was associated with fewer major complications; leaves open whether technique or selection drove the trend.
BACKGROUND: Endomyocardial biopsy (EMB) is a safe procedure performed in diagnostic work-up of cardiac disease. HYPOTHESIS: Data regarding temporal trends of total numbers, characteristics, in-hospital outcomes, and complications of patients undergoing EMB are sparse. METHODS: The nationwide German inpatient sample (2005-2019) was used for this analysis. Patient cases of EBM during the 5-year cycles from 2005 to 2009, 2010 to 2014, and 2015 to 2019 were compared, and temporal trends regarding total numbers and presumable major and minor EMB-associated complications were investigated. RESULTS: Overall, 67 745 EMB were performed in Germany 2005-2019. Total number of EMB increased from 3083 in 2005 to 5646 in 2019 (β 0.40 [95% confidence interval [CI] 0.37-0.43], p < .001). Among these EMB, 19 083 (28.2%) were performed during the period 2005-2009, 22 867 (33.7%) 2010-2014, and 25 795 (38.1%) between 2015 and 2019. The proportion of patients aged ≥70 years was highest 2015-2019 (2005-2009: 9.3%; 2010-2014: 13.8%; 2015-2019: 16.1%, p < .001) and the most aggravated comorbidity profile (Charlson Comorbidity Index 2.25 ± 1.93; 2.67 ± 2.14; 3.01 ± 2.29, p < .001) was also detected 2015-2019. Major complications occurred less often in the period 2015-2019 compared to 2005-2009 (odds ratio [OR] 0.921 [95% CI 0.893-0.950], p < .001), whereas minor complications were more frequently observed between 2015 and 2019 (OR 1.067 [95% CI 1.042-1.093], p < .001). While a decrease in major complications was detected irrespective of age, an increase in minor complications was identified only in patients between 30-59 years. CONCLUSIONS: Annual numbers of EMB increased significantly in Germany 2005-2019. Patients who underwent EMB in recent years were older and showed an aggravated comorbidity profile accompanied by fewer major complications, underscoring safety of the procedure.
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Keller et al. (2023) conducted an observational in Cardiac disease (n=67,745). Endomyocardial biopsy vs. Historical cohort (2005-2009) was evaluated on Major complications (OR 0.921, 95% CI 0.893-0.950, p=< .001). The annual number of endomyocardial biopsies in Germany increased significantly from 2005 to 2019, accompanied by a decrease in major complications (OR 0.921; 95% CI 0.893-0.950; p<0.001).
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