Abstract 16361: Outcomes, and Cost in Patients With End-Stage Renal Disease Treated With Either Transcatheter or Surgical Aortic Valve Replacement
Introduction: Transcatheter aortic valve replacement (TAVR) has emerged as a viable alternative to surgical replacement (SAVR) for treating patients with severe aortic stenosis (AS). The data on aortic valve replacement in patients with end stage renal disease (ESRD) is scarce. We aimed to compare the in-hospital outcomes, and cost of TAVR versus SAVR in ESRD patients.
Methods: We used the Agency for healthcare Research and Quality Healthcare Cost and Utilization Project National Inpatient Sample dataset for the year 2013. International Classification of Diseases Version 9 (ICD-9) was used for diagnosis and procedure codes. Patients < 50 years of age and who concomitantly underwent other valvular procedures were excluded. We matched the TAVR and SAVR group patients using propensity scores from patient characteristics (age and gender) and Charlson comorbidity index. We compared in-hospital mortality, in-hospital complications (vascular, neurological, and cardiac), length of stay, and overall hospital costs between the two groups.
Results: Out of 182,809 patients with ESRD, 383 patients met our inclusion criteria. The TAVR and SAVR groups comprised of 108 patients and 275 patients respectively. We found no differences in the Charlson Comorbidity Index between the two groups; however, the patients undergoing TAVR were older. On propensity score matching, mortality was lower in the TAVR group, but the difference was not statistically significant. The TAVR group had significantly lower complications (41.67% vs 59.57%), shorter length of stay (8.98 versus 21.61 days) and lower total in-hospital costs. (Table 1)
Conclusions: Our findings suggest that TAVR is associated with lower rates of in-hospital complications, lower costs, and shorter length of stay as compared to SAVR, despite selecting older patients.
Author Disclosures: V. Bhise: None. P. Kanade: None. P. Balan: None. T. Nguyen: None. A.L. Estrera: None. R. Smalling: None. A. Dhoble: None.
- © 2016 by American Heart Association, Inc.