TY  - BOOK
AU  - Chothani, Ankit
TI  - Comparison of Inhospital Outcomes of Surgical Aortic Valve Replacement in Hospitals With and Without Availability of a Transcatheter Aortic Valve Implantation Program (from a Nationally Representative Database)
SN  - 1879-1913
PY  - 2015///
KW  - *Cardiac Care Facilities/sn [Statistics & Numerical Data]
KW  - *Heart Defects, Congenital/su [Surgery]
KW  - *Heart Valve Diseases/su [Surgery]
KW  - *Transcatheter Aortic Valve Replacement
KW  - Aged
KW  - Aged, 80 and over
KW  - Aortic Valve/su [Surgery]
KW  - Databases, Factual
KW  - Female
KW  - Heart Defects, Congenital/di [Diagnosis]
KW  - Heart Valve Diseases/di [Diagnosis]
KW  - Hospital Mortality
KW  - Hospitalization/sn [Statistics & Numerical Data]
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Propensity Score
KW  - Treatment Outcome
KW  - United States
KW  - MedStar Washington Hospital Center
KW  - Medicine/General Internal Medicine
KW  - Comparative Study
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - We hypothesized that the availability of a transcatheter aortic valve implantation (TAVI) program in hospitals impacts the overall management of patients with aortic valve disease and hence may also improve postprocedural outcomes of conventional surgical aortic valve replacement (SAVR). The aim of the present study was to compare the inhospital outcomes of SAVR in centers with versus without availability of a TAVI program in an unrestricted large nationwide patient population >50 years of age. SAVRs performed on patients aged >50 years were identified from the Nationwide Inpatient Sample (NIS) for the years 2011 and 2012 using the International Classification of Diseases, Ninth Revision, Clinical Modification procedure codes. SAVR cases were divided into 2 categories: those performed at hospitals with a TAVI program (SAVR-TAVI) and those without (SAVR-non-TAVI). A total of 9,674 SAVR procedures were identified: 4,526 (46.79%) in the SAVR-TAVI group and 5,148 (53.21%) in SAVR-non-TAVI group. The mean age of the study population was 70.2 +/- 0.1 years with majority (53%) of the patients aged >70 years. The mean Charlson's co-morbidity score for patients in SAVR-TAVI group was greater (greater percentage of patients were aged >80 years, had hypertension, congestive heart failure, renal failure, and peripheral arterial disease) than that of patients in SAVR-non-TAVI group (1.6 vs 1.4, p <0.001). The propensity score matching analysis showed a statistically significant lower inhospital mortality (1.25% vs 1.72%, p = 0.001) and complications rate (35.6% vs 37.3%, p = 0.004) in SAVR-TAVI group compared to SAVR-non-TAVI group. The mean length of hospital stay was similar in the 2 groups the cost of hospitalization was higher in the SAVR-TAVI group (
UR  - http://dx.doi.org/10.1016/j.amjcard.2015.07.039
ER  -