In-hospital outcomes of transapical versus surgical aortic valve replacement : from the U.S. national inpatient sample
Copyright and License information: Journal of Geriatric Cardiology 2021..
OBJECTIVE: To compare the outcomes of transapical transcatheter aortic valve replacement (TA-TAVR) and surgical aortic valve replacement (SAVR) using a large US population sample.
METHODS: The U.S. National Inpatient Sample was queried for all patients who underwent TA-TAVR or SAVR during the years 2016-2017. The primary outcome was all-cause in-hospital mortality. Secondary outcomes were in-hospital stroke, pericardiocentesis, pacemaker insertion, mechanical ventilation, vascular complications, major bleeding, acute kidney injury, length of stay, and cost of hospitalization. Outcomes were modeled using multi-variable logistic regression for binary outcomes and generalized linear models for continuous outcomes.
RESULTS: A total of 1560 TA-TAVR and 44,280 SAVR patients were included. Patients who underwent TA-TAVR were older and frailer. Compared to SAVR, TA-TAVR correlated with a higher mortality (4.5% vs. 2.7%, effect size (SMD) = 0.1) and higher periprocedural complications. Following multivariable analysis, both TA-TAVR and SAVR had a similar adjusted risk for in-hospital mortality. TA-TAVR correlated with lower odds of bleeding with (adjusted OR (aOR) = 0.26; 95% CI: 0.18-0.38;P < 0.001), and a shorter length of stay (adjusted mean ratio (aMR) = 0.77; 95% CI: 0.69-0.84; P < 0.001), but higher cost (aMR = 1.18; 95% CI: 1.10-1.28; P < 0.001). No significant differences in other study outcomes. In subgroup analysis, TA-TAVR in patients with chronic lung disease had higher odds for mortality (aOR = 3.11; 95%CI: 1.37-7.08; P = 0.007).
CONCLUSION: The risk-adjusted analysis showed that TA-TAVR has no advantage over SAVR except for patients with chronic lung disease where TA-TAVR has higher mortality.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:18 |
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| Enthalten in: |
Journal of geriatric cardiology : JGC - 18(2021), 9 vom: 28. Sept., Seite 702-710 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Abugroun, Ashraf [VerfasserIn] |
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| Anmerkungen: |
Date Revised 22.10.2021 published: Print Citation Status PubMed-not-MEDLINE |
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| doi: |
10.11909/j.issn.1671-5411.2021.09.005 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM331997746 |
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| 500 | |a published: Print | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright and License information: Journal of Geriatric Cardiology 2021. | ||
| 520 | |a OBJECTIVE: To compare the outcomes of transapical transcatheter aortic valve replacement (TA-TAVR) and surgical aortic valve replacement (SAVR) using a large US population sample | ||
| 520 | |a METHODS: The U.S. National Inpatient Sample was queried for all patients who underwent TA-TAVR or SAVR during the years 2016-2017. The primary outcome was all-cause in-hospital mortality. Secondary outcomes were in-hospital stroke, pericardiocentesis, pacemaker insertion, mechanical ventilation, vascular complications, major bleeding, acute kidney injury, length of stay, and cost of hospitalization. Outcomes were modeled using multi-variable logistic regression for binary outcomes and generalized linear models for continuous outcomes | ||
| 520 | |a RESULTS: A total of 1560 TA-TAVR and 44,280 SAVR patients were included. Patients who underwent TA-TAVR were older and frailer. Compared to SAVR, TA-TAVR correlated with a higher mortality (4.5% vs. 2.7%, effect size (SMD) = 0.1) and higher periprocedural complications. Following multivariable analysis, both TA-TAVR and SAVR had a similar adjusted risk for in-hospital mortality. TA-TAVR correlated with lower odds of bleeding with (adjusted OR (aOR) = 0.26; 95% CI: 0.18-0.38;P < 0.001), and a shorter length of stay (adjusted mean ratio (aMR) = 0.77; 95% CI: 0.69-0.84; P < 0.001), but higher cost (aMR = 1.18; 95% CI: 1.10-1.28; P < 0.001). No significant differences in other study outcomes. In subgroup analysis, TA-TAVR in patients with chronic lung disease had higher odds for mortality (aOR = 3.11; 95%CI: 1.37-7.08; P = 0.007) | ||
| 520 | |a CONCLUSION: The risk-adjusted analysis showed that TA-TAVR has no advantage over SAVR except for patients with chronic lung disease where TA-TAVR has higher mortality | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Taha, Ahmed |e verfasserin |4 aut | |
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| 700 | 1 | |a Awadalla, Saria |e verfasserin |4 aut | |
| 700 | 1 | |a Daoud, Hussein |e verfasserin |4 aut | |
| 700 | 1 | |a Igbinomwanhia, Efehi |e verfasserin |4 aut | |
| 700 | 1 | |a Klein, Lloyd W |e verfasserin |4 aut | |
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