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Clinical Outcomes in Relation to Total Hospital Surgical and Transcatheter Aortic Valve Replacement Volumes.
Elbadawi, Ayman; Mohamed, Amr; Sedhom, Ramy; Garcia, Lisardo; Pandey, Ambarish; Girotra, Saket; Bavry, Anthony; Vemulapalli, Sreekanth; Kumbhani, Dharam J.
Afiliación
  • Elbadawi A; Division of Cardiology Christus Good Shepherd Medical Center Longview TX.
  • Mohamed A; Texas A&M School of Medicine Bryan TX.
  • Sedhom R; Division of Cardiology Allegheny General Hospital Pittsburg PA.
  • Garcia L; Division of Cardiology Loma Linda University Loma Linda CA.
  • Pandey A; Division of Cardiothoracic Surgery Christus Good Shepherd Medical Center Longview TX.
  • Girotra S; Division of Cardiology, Department of Medicine University of Texas Southwestern Dallas TX.
  • Bavry A; Division of Cardiology, Department of Medicine University of Texas Southwestern Dallas TX.
  • Vemulapalli S; Division of Cardiology, Department of Medicine University of Texas Southwestern Dallas TX.
  • Kumbhani DJ; Duke Clinical Research Institute Durham NC.
J Am Heart Assoc ; : e035719, 2024 Sep 18.
Article en En | MEDLINE | ID: mdl-39291503
ABSTRACT

BACKGROUND:

There is a paucity of data regarding the relationship between overall hospital volumes for total aortic valve replacement (AVR; transcatheter AVR [TAVR] or surgical AVR [SAVR]) and patient outcomes. METHODS AND

RESULTS:

We queried the 2019 Nationwide Readmission Database for patients undergoing AVR. Based on procedural volumes of TAVR or SAVR, we classified hospitals as high (≥50th percentile) or low (<50th percentile) volume centers and categorized hospitals as high TAVR/high SAVR, high TAVR/low SAVR, high SAVR/low TAVR, and low TAVR/low SAVR. Multivariable regression models were employed. The main study outcomes were in-hospital mortality and 30-day readmission after total AVR. Our final analysis included 72 123 patients undergoing AVR at 400 hospitals across the United States. The median (interquartile range) hospital procedural volumes for total AVR, TAVR, and SAVR were 137 (86-210), 82 (50-127), and 56 (31-87) procedures, respectively. There was an inverse correlation between hospital procedural volumes of AVR, TAVR, or SAVR and in-hospital mortality after total AVR but not with 30-day readmission. Using high TAVR/high SAVR hospitals as reference, there was higher in-hospital mortality after total AVR among low TAVR/low SAVR hospitals (adjusted odds ratio [OR], 1.29 [95% CI, 1.07-1.56]) but similar in-hospital mortality among high TAVR/low SAVR hospitals and low TAVR/high SAVR volumes. There was no difference in 30-day readmission rates after total AVR among the 4 hospital categories.

CONCLUSIONS:

Nationwide data revealed that in-hospital mortality after total AVR (SAVR or TAVR) is inversely related to hospital total volumes of AVR. Patients with aortic stenosis have better outcomes if they are managed among experienced centers with high case volumes of both TAVR and SAVR.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Am Heart Assoc Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Am Heart Assoc Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido