Abstract 16641: Effect of Annual Hospital Volume on Mortality & Complication Related to MitraClip Placement in US: Analysis of 475 Procedures
Background: Limited data is available regarding the effect of annual hospital volume on mortality/complications related to MitraClip placement. We aimed to assess predictors of mortality/complication of MitraClip placement using Nationwide Inpatient Sample (NIS).
Methods: We queried NIS from year 2010 to 2011 using ICD-9-CM procedure code of 35.97 for percutaneous mitral valve repair with implant. Pre-existing comorbidities were defined using Charlson Comorbidity Index (CCI). Annual hospital volume was defined using unique hospital identifier for individual year. Complications were calculated using ICD-9-CM codes & Patient Safety Indicators (PSI) designed by Agency for Healthcare Research & Quality (AHRQ). Major categories of complications included: vascular, cardiac, respiratory, neurological & renal. Hierarchical mixed effect regression model was created to assess predictors of mortality/complication.
Results: Total of 95 (weighted to entire US population = 475) procedures were analyzed. Average age was 70 years and majority of the patients were male (65%), white (65%) with hypertension (72%). Most of the procedures were performed in large (87%), teaching hospitals (80%). Peri-procedural mortality was 2.1% & complications were 20%. Majority of complications included cardiac (9.5%), vascular (7.4%) & respiratory (6.3%). 3.2% patient required ASD repair after the procedure & 2.1% procedure were performed with intra-cardiac echocardiography (ICE) guidance. Multivariate analysis showed increased mortality/complication was associated with highest tertile of CCI (OR 8.23, 95% CI 1.48-45.6, P=0.02) & annual hospital volume associated with lower mortality/complication (Tertile 2: OR 0.13, 95% CI 0.02-0.94, p=0.04; Tertile 3: OR 0.05, 95% CI 0.01-0.55, p=0.02).
Conclusion: Increase in annual hospital procedural volume is associated with lower mortality/complication. Cardiac & Vascular complications are more common with MitraClip placement.
Author Disclosures: A. Chothani: None. S. Manvar: None. B. Thakkar: None. N. Patel: None. V. Panchal: None. V. Singh: None. A. Rathod: None. S. Arora: None. N.J. Patel: None. S. Pant: None. J. Patel: None. S. Solanki: None. A. Patel: None. G. Dhaduk: None. N. Patel: None. P. Grover: None. N. Shah: None. A. Deshmukh: None. A.O. Badheka: None. R. Sachdeva: None.
- © 2014 by American Heart Association, Inc.