Abstract 15746: Trends in the Hospitalization Rates and Outcomes of Patients With Aortic Stenosis From 2004 to 2013
Background: An aging population and the introduction of transcatheter aortic valve replacement (TAVR) have led to a major shift in how patients with aortic stenosis (AS) are managed. Although there is a need to understand the epidemiological aspects of AS for future resource planning, few studies have characterized recent trends in hospitalization and outcomes of these patients.
Methods: We performed an observational study using population-based data in Ontario, Canada. Patients with a first hospitalization for a primary or secondary diagnosis of AS between 2004 and 2013 were included. The annual rates of AS-related hospitalization were determined and standardized by the Ontario population. Rates of aortic valve intervention and all-cause mortality at 30 days and 1 year after index hospitalization were assessed. The Cochrane-Armitage test was used to evaluate temporal trends. Logistic regression models were used to evaluate adjusted mortality.
Results: A total of 37,970 patients were hospitalized with AS during the study period. The age- and sex-standardized hospitalization rate for AS increased from 36 to 39 per 100,000 between 2004 and 2013 (p <0.001). However, much of the change was seen in patients ≥85 years, where rates increased from 400 to 516 per 100,000 (p <0.001), representing a relative increase of 31% (Figure). The proportion of patients who underwent aortic valve intervention within 1 year of hospitalization increased from 39% to 44% (p <0.001), with the largest increase in those ≥85 years (5% to 18%; p<0.001). Overall unadjusted 30 day and 1 year mortality rates after hospitalization were 12% and 26%, respectively. No significant temporal change in adjusted mortality was observed.
Conclusion: Over the past decade when TAVR was introduced, rates of AS hospitalization have significantly increased in the elderly, beyond that expected with population growth. While rates of intervention have also increased, this has not been associated with a change in mortality.
Author Disclosures: A. Czarnecki: None. D.A. Alter: None. P.C. Austin: None. S.E. Fremes: Honoraria; Modest; Medtronic. M. Koh: None. J.V. Tu: None. H.C. Wijeysundera: Research Grant; Significant; Edwards Lifesciences. A.T. Yan: Research Grant; Significant; Astra-Zeneca. D.T. Ko: None.
- © 2016 by American Heart Association, Inc.