Impact of sex on short term in-hospital outcomes with transcatheter edge-to-edge mitral valve repair

Doshi, Rajkumar; Shlofmitz, Evan; Vadher, Abhishek; Shah, Jay; Meraj, Perwaiz

doi:10.1016/j.carrev.2017.07.002

Cited by 17 publications

(32 citation statements)

References 24 publications

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“…13 The NIS database has been described previously. 14 comorbidities in our study. 16 Additional comorbidities were included using ICD-9-CM codes (see Supporting Information, Table 1, in the online version of this article).…”

Section: Study Design and Patient Populationmentioning

confidence: 62%

“…Our retrospective, observational cohort study's population is derived from the National Inpatient Sample (NIS) database . The NIS database has been described previously . Briefly, NIS is a part of the Healthcare Cost and Utilization Project (HCUP), which is sponsored by the Agency for Healthcare Research and Quality (AHRQ).…”

Section: Methodsmentioning

confidence: 99%

“…We used secondary diagnosis or procedural codes to identify in‐hospital outcomes. A similar selection process for outcomes has been used previously . Additionally, we included length of hospitalization stay and mean cost of hospitalization.…”

Section: Methodsmentioning

confidence: 99%

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Transcatheter or surgical aortic valve replacement in patients with advanced kidney disease: A propensity score–matched analysis

Doshi

Shah

Patel

et al. 2017

Clinical Cardiology

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Background Transcatheter aortic valve replacement (TAVR) is an alternative for surgically inoperable patients with severe aortic stenosis. Advanced kidney disease may significantly affect outcomes in patients treated with TAVR and surgical aortic valve replacement (SAVR). Hypothesis TAVR is associated with better in‐hospital outcomes compared with SAVR in patients with advanced kidney disease. Methods We identified our sample from the National Inpatient Sample between 2012 and 2014, using International Classification of Diseases, Ninth Revision, Clinical Modification codes. We included patients with chronic kidney disease stages IV and V and end‐stage renal disease as advanced kidney disease patients. We excluded patients with acute kidney injury on admission and patients on dialysis. Results After propensity matching, 2485 patients were included in each group. The primary outcome of in‐hospital mortality (12.9% vs 6.2%; P < 0.01) was higher with SAVR as compared with TAVR. Patients who underwent SAVR reported higher acute kidney injury (50.3% vs 33%; P < 0.01) and dialysis requirements (26.8% vs 20.1%; P < 0.01). Other secondary outcomes including blood transfusion, atrial fibrillation, iatrogenic cardiac complications, pericardial complications, perioperative stroke, perioperative infections, and postoperative shock were more common with SAVR. With SAVR, the length of hospitalization and hospitalization costs were significantly higher; however, permanent pacemaker placement was more common with TAVR compared with SAVR. Conclusions In patients with advanced kidney disease, SAVR was associated with higher mortality and higher periprocedural complications, as compared with TAVR. Thus, benefits of TAVR could be extended in patients with advanced kidney disease who cannot undergo surgery.

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Section: Study Design and Patient Populationmentioning

confidence: 62%

Section: Methodsmentioning

confidence: 99%

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Transcatheter or surgical aortic valve replacement in patients with advanced kidney disease: A propensity score–matched analysis

Doshi

Shah

Patel

et al. 2017

Clinical Cardiology

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“…Second in the NIS database, variables are identified using a coding system that is subject to coding errors and documentation disparities. However, the NIS data have been widely used and validated . Lastly, our study is limited to the in‐hospital outcomes; follow‐up data were not reported.…”

Section: Discussionmentioning

confidence: 99%

“…All the patients who underwent TMVR (age ≥18 years) from 2011 to 2014 were included (procedure codes of 35.97) were included. The approach of identifying TMVR hospitalizations according to ICD‐9‐CM codes have been used in prior work examining the NIS . The included TMVR patients were then stratified into two major groups based on the presence or absence of AF.…”

Section: Methodsmentioning

confidence: 99%

The impact of atrial fibrillation on transcatheter mitral valve repair outcomes: A propensity‐matched analysis

Subahi

Ahmad

Abubakar

et al. 2018

J Interven Cardiology

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Background:The concomitant presence of atrial fibrillation (AF) in the setting of Transcatheter Mitral Valve Repair (TMVR) represents a clinical challenge. Despite the high AF burden in patients presenting for the TMVR procedure, there are no studies that evaluate the impact of AF on in-hospital outcomes of TMVR in a nationally representative United States sample reflecting real practice. Therefore, we sought to study the outcomes of AF patients undergoing TMVR. Methods and Results:The study included 1026 patients from the National Inpatient Sample (NIS) registry. Patients (age ≥18 years) who had undergone TAVR as a primary procedure from 2011 to 2014 were included, using the ICD-9-CM diagnostic codes.We examined patient characteristics and in-hospital outcomes. To account for patient and hospital-level baseline differences, we performed propensity score-matched analysis. The prevalence of AF was approximately 56%. After adjusting for patientlevel and hospital-level characteristics, there was no statistical difference regarding in-hospital mortality (odds ratio [OR] 0.72, 95%CI 0.29-1.80, P = 0.487), post-TMVR complications, length of stay (OR 1.15, 95%CI 0.97-1.38, P = 0.111), and cost of hospitalization (OR 1.04, 95%CI 0.94-1.14, P = 0.475) between the group with AF versus without AF. However, patients with AF were more likely to have non-routine hospital discharge (42.94% vs 35.48% P = 0.02).Conclusion: AF is a frequently encountered arrhythmia among patients undergoing TMVR with MitraClip. However, TMVR can be performed safely in the vast majority of patients, irrespective of their baseline rhythm. K E Y W O R D S atrial fibrillation, length of stay, transcatheter mitral valve repair

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Impact of gender on in‐hospital mortality and 90‐day readmissions in patients undergoing transcatheter edge‐to‐edge mitral valve repair: Analysis from the National Readmission Database

Guddeti

Pajjuru

Walters

et al. 2021

Cathet Cardio Intervent

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Background: Patients undergoing transcatheter edge-to-edge mitral valve repair (TEER) carry a high risk of rehospitalization due to disease, procedure, patient, hospital, and system related factors.Aims: We aimed to explore the impact of gender on in-hospital mortality and 90-day readmissions in patients undergoing TEER.Methods: We utilized the National Readmission Database from 2012 to 2018 to identify individuals who underwent TEER for mitral regurgitation. Gender-based differences in in-hospital mortality and 90-day readmissions were explored using multivariable logistic regression models.Results: Between 2012 and 2018, an estimated 21,415 TEER procedural hospitalizations were identified, of which 9893 (46.2%) were in women and 11,522 (53.8%) were in men. Compared with men, women were older, from a lower socioeconomic status but had a lower co-morbidity burden. In-hospital mortality rate during the index hospitalization was similar in women and men (2.1% vs. 2.1%, p = 0.908). Ninety-day allcause and heart failure readmission rates were significantly higher in women compared to men (30.2% vs. 25.4%; p < 0.001 and 28.1% vs. 23.9%; p = 0.020 respectively). In a multivariable analysis, women had 36% greater odds of 90-day readmission compared to men (adjusted odds ratio [aOR] 1.36, 95% CI: 1.22-1.52; p < 0.001). Trend analysis revealed no significant improvement in rates of 90-day readmission during the observation period for men or women (p = 0.245, p = 0.429, respectively).Conclusions: Following TEER, there has been no significant improvement in 90-day readmission rates between 2012 and 2018. Female gender is associated with higher 90-day all-cause and heart failure readmission rates.

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Impact of sex on short term in-hospital outcomes with transcatheter edge-to-edge mitral valve repair

Cited by 17 publications

References 24 publications

Transcatheter or surgical aortic valve replacement in patients with advanced kidney disease: A propensity score–matched analysis

Transcatheter or surgical aortic valve replacement in patients with advanced kidney disease: A propensity score–matched analysis

The impact of atrial fibrillation on transcatheter mitral valve repair outcomes: A propensity‐matched analysis

Impact of gender on in‐hospital mortality and 90‐day readmissions in patients undergoing transcatheter edge‐to‐edge mitral valve repair: Analysis from the National Readmission Database

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