Evolving Patterns of Vascular Lab Testing in the Hospital and Private Lab Settings

Abstract

Introduction

We evaluated laboratory use in a 600–bed community hospital and a private practice lab. The study spanned from 1996 to 2007.

Method

The hospital laboratory used 5 duplex scanners and 2 physiologic plethysmography units and was staffed by 7 technologists. The private laboratory expanded over time, growing from 4 technologists with 4 duplex scanners and 1 physiologic machine to 7 technologists, 7 duplex scanners, and 3 physiologic units in 2007.

Results

A total of 43.5% of tests performed in the hospital were venous tests in 1999 and 55.5% in 2007. Cerebrovascular scans decreased (32.8% to 23.1%). Lower-extremity arterial tests also decreased. Other tests were uncommon (394 tests, or 5.1%). In the private lab cerebrovascular duplex scans decreased from 36.9% to 24.4%. Lower-extremity physiologic studies remained stable. Aortic scans became more common. Lower-extremity venous scans accounted for 14.2% of studies in 1996 and 11.8% in 2007 but with twice the number of tests.

Conclusion

The hospital laboratory is predominantly involved in the diagnosis of venous thrombosis and cerebrovascular events. The less-used and uncommon studies such as upper-extremity arterial studies and dialysis access studies remain uncommon but are performed in greater volume in the private lab than the hospital.