Abstract 18166: Comparison of Surgical Aortic Valve Replacement and Transcatheter Aortic Valve Replacmeent: Analysis From Nationwide Inpatient Sample
Introduction: Transcatheter aortic valve replacement (TAVR) is the newer modality recently approved by FDA for patients with severe aortic stenosis deemed inoperable or high risk for surgical aortic valve replacement (SAVR).
Hypothesis: This study was done to compare demographics, length of stay (LOS), mean charges and in-hospital mortality of patients undergoing TAVR and SAVR procedures in the United States for years 2012 and 2013.
Methods: We used Nationwide Inpatient Sample (NIS) data to extract data for patients who were hospitalized with a primary diagnosis of TAVR and SAVR as specified by International Classification of Disease code 35.05, 35.06 and 35.21, 35.22 respectively. NIS data is 20% representative of all hospital data in USA. Data was extracted for the year 2012-2013 and various parameters associated with TAVR and SAVR were analyzed.
Results: A total of 117,610 and 18,925 hospitalizations associated with primary diagnosis of SAVR and TAVR procedures were identified respectively. Mean chargers were lower for SAVR compared to TAVR ($50,225 vs. $137,221). Most of patients were 65-84 years (61.2%) in the SAVR group while in the TAVR group majority were >85 years age (45.42%). Mean length of stay was 10.1 days and 8.0 days with in-hospital mortality of 3.07% and 4.76% for SAVR and TAVR groups respectively. More males (63.68%) were undergoing SAVR when compared males undergoing TAVR (47.71%). Both for SAVR and TAVR the main insurance was Medicare (>64%) and belonged to not low income by household (>70%). Both the procedures were performed mostly at private, not-for profit, urban, large bedsize teaching centers (>70%). Both procedures were performed with highest numbers in the south (>35%).
Conclusions: This is perhaps the first study comparing the different demographics of patients undergoing SAVR and TAVR. As TAVR is performed patients deemed high risk for SAVR, it is expected to have higher in-hospital mortality for these patients with more number of older patients undergoing TAVR. However, the mean LOS was less for TAVR patients. It is important to understand the type high-risk patients undergoing TAVR which is a newer intervention and further strategies to reduce in-hospital mortality and costs for patients undergoing TAVR should be undertaken.
Author Disclosures: Y. Agrawal: None. S. Patri: None. S. Aggarwal: None. S. Patri: None. C. Jacob: None. F. Saltiel: None. J.K. Kalavakunta: None. V. Gupta: None.
- © 2016 by American Heart Association, Inc.