Abstract 13606: Is Pulmonary Hypertension a Poor Prognostic Sign in Patients Hospitalized for Transcatheter Aortic Valve Replacement

Abstract

Introduction: Pulmonary hypertension (PH) is common in patients with severe aortic stenosis (AS). The prevalence of PH in transcatheter aortic valve replacement (TAVR) patients is reported upto 78% and causes significant morbidity and mortality. We queried the National Inpatient Sample (NIS) database to explore the different outcomes of patients hospitalized for TAVR with and without the history of PH. Hypothesis: PH may increase mortality in hospitalized patients undergoing TAVR. Methods: This is a retrospective cohort study utilizing the 2016-2017 National Inpatient Sample. We identified patients hospitalized for TAVR with and without the history of PH using ICD10 codes. The primary outcome was inpatient mortality. The secondary outcomes were cost of hospitalization, and length of stay (LOS). Multivariate regression was used to adjust for potential confounders including age, gender, race, pulmonary embolism, acute coronary syndrome, heart block, left bundle branch block (LBBB), diabetes, heart failure, and chronic kidney disease. STATA 15.0 was utilized for data analysis. Results: A total of 18221 patients underwent TAVR in 2016-2017. Of these, 18.3% had PH. There were more women in the PH group (51% vs 46%, P<0.001). Patients were relatively younger in the PH group (79 yrs vs 80 yrs; p<0.001). The mean cost of hospitalization was 23022 USD in the PH group versus 209867 USD in the group without PH (p< 0.001). The patients in the PH group had higher inpatient mortality compared to patients without PH (2.28 % versus 1.49 %; Odds Ratio 1.54; p< 0.001; CI 1.1-2.0). The mean LOS was 6.0 days in the PH group versus 4.3 days in those without the PH group ( p:< 0.001). The mortality didn’t differ by gender, location of the hospital, and teaching status of the hospital. Conclusions: Our study showed higher inpatient mortality, length of stay, and cost of hospitalization in patients undergoing TAVR with PH as compared to those without PH.