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Balloon mitral valvuloplasty in the United States: a 13-year perspective.

MedStar author(s):

Citation: American Journal of Medicine. 127(11):1126.e1-12, 2014 Nov.PMID: 24859718Institution: MedStar Washington Hospital CenterDepartment: Medicine/General Internal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Balloon Valvuloplasty/ut [Utilization] | *Hospitalization/ec [Economics] | *Mitral Valve Stenosis/th [Therapy] | Age Distribution | Balloon Valvuloplasty/ae [Adverse Effects] | Balloon Valvuloplasty/ec [Economics] | Balloon Valvuloplasty/td [Trends] | Comorbidity | Continental Population Groups/sn [Statistics & Numerical Data] | Cross-Sectional Studies | Databases, Factual | Female | Hospital Mortality | Humans | Length of Stay/sn [Statistics & Numerical Data] | Length of Stay/td [Trends] | Male | Medicaid | Medicare | Middle Aged | Mitral Valve Stenosis/ep [Epidemiology] | United States/ep [Epidemiology]Year: 2014 Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - presentISSN:

0002-9343

Name of journal: The American journal of medicineAbstract: BACKGROUND: Incidence and prevalence of mitral stenosis is declining in the US. We performed this study to determine recent trends in utilization, complications, mortality, length of stay, and cost associated with balloon mitral valvuloplasty.CONCLUSIONS: In a large cross-sectional study of balloon mitral valvuloplasty in the US, we have reported trends of decreasing overall utilization and increasing procedural complication rates and cost over a period of 13 years.Copyright � 2014 Elsevier Inc. All rights reserved.METHODS: Utilizing the nationwide inpatient sample database from 1998 to 2010, we identified patients using the International Classification of Diseases, 9th Revision, Clinical Modification procedure code for "percutaneous valvuloplasty." Patients >18 years of age with mitral stenosis were included. Patients with concomitant aortic, tricuspid, or pulmonic stenosis were excluded. Primary outcome included death and procedural complications.RESULTS: A total of 1308 balloon mitral valvuloplasties (weighted n = 6540) were analyzed. There was a 7.5% decrease in utilization of the procedure from 24.6 procedures/10 million population in 1998-2001 to 22.7 procedures/10 million population in 2008-2010 (P for trend = .098). We observed a 15.9% overall procedural complication rate and 1.7% mortality rate. The procedural complication rates have increased in recent years (P = .001), corresponding to increasing age and burden of comorbidities in patients. The mean cost per admission for balloon mitral valvuloplasty has gone up significantly over the 10 years, from All authors: Alfonso C, Arora S, Badheka AO, Bhalara V, Chothani A, Cohen MG, de Marchena E, Desai H, Deshmukh A, Ghatak A, Grines C, Grover P, Kar S, Makkar R, Mehta K, O'Neill W, Palacios IF, Panaich SS, Patel N, Patel NJ, Rathod A, Rihal CS, Savani GT, Schreiber T, Shah N, Singh VFiscal year: FY2015Digital Object Identifier:

http://dx.doi.org/10.1016/j.amjmed.2014.05.015

Date added to catalog: 2015-03-17

Holdings ( 1 )
Title notes ( 6 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	24859718	Available		24859718

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - present

BACKGROUND: Incidence and prevalence of mitral stenosis is declining in the US. We performed this study to determine recent trends in utilization, complications, mortality, length of stay, and cost associated with balloon mitral valvuloplasty.

CONCLUSIONS: In a large cross-sectional study of balloon mitral valvuloplasty in the US, we have reported trends of decreasing overall utilization and increasing procedural complication rates and cost over a period of 13 years.Copyright � 2014 Elsevier Inc. All rights reserved.

METHODS: Utilizing the nationwide inpatient sample database from 1998 to 2010, we identified patients using the International Classification of Diseases, 9th Revision, Clinical Modification procedure code for "percutaneous valvuloplasty." Patients >18 years of age with mitral stenosis were included. Patients with concomitant aortic, tricuspid, or pulmonic stenosis were excluded. Primary outcome included death and procedural complications.

RESULTS: A total of 1308 balloon mitral valvuloplasties (weighted n = 6540) were analyzed. There was a 7.5% decrease in utilization of the procedure from 24.6 procedures/10 million population in 1998-2001 to 22.7 procedures/10 million population in 2008-2010 (P for trend = .098). We observed a 15.9% overall procedural complication rate and 1.7% mortality rate. The procedural complication rates have increased in recent years (P = .001), corresponding to increasing age and burden of comorbidities in patients. The mean cost per admission for balloon mitral valvuloplasty has gone up significantly over the 10 years, from 1, 668 +/- 1046 in 2001 to 3, 651 +/- 301 in 2010 (P <.001).

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