C-75 | Fatigue Impacts Operator Decision Making During Left-Main Percutaneous Coronary Intervention

Background: Fatigue is a state of impaired performance resulting from excessive mental or physical activity.Despite Evidence suggesting that fatigue can contribute to poor patient outcomes in surgical cases, limited attempts have been made to investigate the role of fatigue in interventional cardiology.Methods: In this retrospective single center study, we analyzed data from all non-emergent left main (LM) percutaneous coronary interventions (PCI) taking place between 1/1/2014 and 1/1/2024.Utilizing case start times as a surrogate for fatigue, we employed logistical regression models to evaluate for discretionary steps performed that would increase case complexity: final kissing balloon inflations, twostent strategies, intravascular ultrasound use and calcium modification techniques.Results: In this patient cohort of 341 nonemergent LM PCIs, a linear inverse correlation between time of day and frequency of IVUS utilization was noted.Time of day did not affect kissing balloon utilization, bifurcation stent strategy, or ancillary calcium modification techniques.Conclusions: We identified significant changes in operator behavior at later time points in the form of reduced IVUS utilization.To our knowledge, this is the first study to identify a potential effect of operator fatigue in the field of interventional cardiology.