Impact of Post-Procedural Evaluation & Management (E&M) Visits on Outcomes Following High-Risk Interventional Radiology Procedures

Purpose: High-risk IR procedures carry risks for early complications & readmissions. While many institutions recommend early post-procedural follow-up, evidence linking structured outpatient visits to outcomes across health systems is limited. Short-interval clinical follow-up after IR procedures was evaluated to determine association with improved outcomes.

Materials and Methods: A retrospective cohort study using TriNetX (2020–2025) was conducted with adults undergoing high-risk IR procedures (CPT codes for biliary drainage/cholecystostomy, nephrostomy/ureteral access, TIPS, tumor embolization, and intra-arterial radiopharmaceutical therapy). Exposure was defined as an outpatient E&M visit within 30 days. Outcomes included ED utilization, inpatient admission, CCS use, infection (pneumonia/UTI/sepsis), and all-cause mortality. Propensity score matching was performed on demographics and comorbidities. Cox proportional hazards models estimated hazard ratios (HRs) with 95% CIs. A sensitivity analysis compared patients followed up within 1–7 vs 8–30 days.

Results: In the unmatched 30-day cohort (n=174,237), E&M+ patients had lower mortality (2.7% vs 8.0%, HR 0.32), inpatient/observation admissions (21.9% vs 41.6%, HR 0.43), and CCS use (4.0% vs 11.7%, HR 0.31), with higher ED utilization (21.2% vs 9.2%, HR 2.31). After matching (n=52,152 per group), these associations persisted. At 90 days, outcomes were consistent with 30-day findings. In the sensitivity analysis, early versus delayed follow-up showed no significant differences in mortality, infection, nor ED/CCS utilization, though early follow-up was associated with significantly higher inpatient and outpatient contact.

Conclusion: Across >100,000 matched patients, < 30 days post-IR procedure E&M visits were strongly associated with lower mortality, inpatient/observation use, CCS utilization, and infections. These findings support standardized post-IR ambulatory follow-up pathways and their incorporation into quality metrics.