Abstract 16430: In-Hospital Outcomes of Patients With End Stage Renal Disease on Dialysis Undergoing Transcatheter Aortic Valve Replacement: Insights From a National Database
Background: The outcomes of patients with end stage renal disease (ESRD) on dialysis who undergo transcatheter aortic valve replacement (TAVR) are not well described due to the exclusion of this group in randomized trials.
Methods: We analyzed the National Inpatient Sample (NIS) database and compared clinical characteristics and in-hospital outcomes for patients with ESRD vs. those without (non-ESRD group) who underwent TAVR in 2011-12 in the United States.
Results: The study population included 785 (8.8%) ESRD patients and 8094 (91.2%) non-ESRD patients. ESRD patients were younger (79.7 ± 8.25 vs. 81.3 ± 9.12 years, p <0.001), had higher prevalence of diabetes (38.1% vs. 32.7%, p<0.01), congestive heart failure (3.2% vs. 1.4%, p<0.01), coagulopathy (38.1% vs. 23.5%, p <0.001) and anemia (39% vs. 27%, p<0.001) (Table 1). After adjusting for clinical and demographic features in a multivariable regression model, ESRD patients had a higher frequency of pacemaker implantation (aOR: 1.46, 95% CI: 1.14-1.86, p<0.01), vascular complications (aOR: 11.34; 95% CI:9.30-13.84, p<0.001) and any adverse outcome (aOR: 7.63; 95% CI: 6.19-9.40, p<0.001) after TAVR. In-hospital mortality (aOR: 1.29; 95% CI: 0.92-1.80, p=0.14) and post-TAVR stroke (aOR: 1.11; 95% CI: 0.56-2.21, p=0.77) were similar in the two groups (Table 2). ESRD patients had longer length of stay (11.41 ± 9.43 vs. 8.27 ± 6.64 days, p<0.001).
Conclusions: ESRD patients on dialysis undergoing TAVR are younger and have more co-morbidities but similar in-hospital mortality compared with non-ESRD patients. However, ESRD patients have a higher frequency of post-TAVR pacemaker implantation and vascular complications.
Author Disclosures: N. Bhatia: None. S. Agrawal: None. D. Mohananey: None. M. Pahuja: None. L. Garg: None. R.G. Soni: None. M. Durkin: None. M. Fegley: None. J. Shirani: None.
- © 2016 by American Heart Association, Inc.