P193 Trends in temporal artery biopsy rates following the COVID-19 pandemic: insights from the Getting It Right First Time programme

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Abstract Background/Aims Timely diagnosis and management of Giant Cell Arteritis (GCA) is essential to prevent serious complications. Temporal artery biopsy (TAB) has historically been the diagnostic gold standard, but, during the COVID-19 pandemic it was not classified as a priority 1 procedure and therefore access to TAB was reduced. We aimed to explore changes in TAB procedure rates in England over the past 14 years, including the pre-, peri-, and post-pandemic periods. Methods All Hospital Episode Statistics Outpatient and Admitted Patient Care records with the procedure code L671 (biopsy of artery) were extracted for analysis. Previous validation work within the Getting It Right First Time (GIRFT) programme demonstrated that, even in the absence of additional procedure coding, procedures coded L671 were almost certainly TAB. Partial financial years were excluded to ensure data completeness. Descriptive statistics were used to summarise trends over time. Results A total of 52,039 TABs were identified over the 13-year period. The mean patient age was 71 years (standard deviation [SD] 10.5), and 65% were female. TAB numbers averaged 4,771 per year (SD 179.9) from 2012/13-2019/20. In 2020/21, coinciding with the COVID-19 pandemic, TAB numbers fell sharply to 2,582, rebounding modestly to 3,272 in 2021/22. Thereafter, TAB numbers remained below pre-pandemic levels through to 2024/25 (mean 2,690, SD 173.0). Conclusion The number of TAB procedures fell by approximately 40% during the pandemic period, illustrating the vulnerability of this diagnostic service and the need for strategies to maintain such activity in future national emergencies. Even after four years, biopsy rates have not returned to pre-pandemic levels. This may partly reflect the increasing use of ultrasound as an alternative first-line diagnostic investigation, as recommended by GIRFT, although there are currently no robust national datasets to evaluate this. Alternatively, the sustained reduction in TAB activity may also reflect a genuine shift in clinical diagnostic pathways. Disclosure R.D. Sandler: None. W.K. Gray: None. L. Martin: None. F. McErlane: None. L.J. Kay: None. P.C. Lanyon: None.