2024 Scientific Sessions

OR12-6
Effects of Artificial Intelligence Clinical Decision Support Tools (Terumo Health Outcomes, ePRISM) on Post-Procedure Bleeding Events in Patients Undergoing Percutaneous Coronary Intervention (PCI)

Presenter

Karley Fischer, MD, Wright State University, Dayton, OH
Karley Fischer, MD1, Damian N. Valencia, MD2, Ashley Dawes, BSN, RN2, Ajay Reddivari, MD, FSCAI2, Ammar Safar, MD2, Ziwar Karabatak, MD, FSCAI2, M. Niranjan Reddy, MD, FSCAI2, Raja A. Nazir, MD2 and Brian Schwartz, MD, FSCAI2, (1)Wright State University, Dayton, OH, (2)Kettering Health, Kettering, OH

Keywords: Quality and Vascular Access, Management, and Closure

Background:
Gastrointestinal bleeding (GIB) is the most frequent non-cardiac complication following percutaneous coronary intervention (PCI). The most frequent procedure related complication is access site bleeding. Prognosis is directly related to bleeding events, with increased 30-day mortality. Advanced artificial intelligence (AI) models have been created which incorporate unique patient characteristics to provide a patient specific bleeding risk and access site recommendation.

Methods:
A retrospective review of patients undergoing PCI at our institution (Kettering Health) from May to November of 2023 was performed. Patients had ePRISM (Terumo Health Outcomes AI Clinical Decision Support Tool) generated risk assessments and access site recommendations (radial or femoral artery) reported by nursing staff during procedure time-out. Statistical analysis was performed to determine incidence of complications and to track changes with implementation.

Results:
A total of N=405 patients were analyzed; 26.2% classified as low risk, 62.6% moderate risk and 11.2% high risk for bleeding complications (GIB and access site bleeding). The incidence of 30-day bleeding complications significantly declined from a baseline of 4.8% to an average of 1.7%. There was a 65% relative reduction in post procedure bleeding complications.

Conclusions:
ePRISM was successfully able to risk stratify patients undergoing PCI for bleeding complications and give meaningful access site recommendations which resulted in a drastic reduction in patient adverse events.