Waqas Ullah
Temporal trends in utilization and outcomes of transcatheter aortic valve replacement in different races: an analysis of the national inpatient sample.
Ullah, Waqas; Al-Khadra, Yasser; Mir, Tanveer; Darmoch, Fahed; Pacha, Homam M.; Sattar, Yasar; Ijioma, Nketchi; Mohamed, Mohamed O.; Kwok, Chun S.; Asfour, Abedelrahim I.; Kapadia, Samir; Rizik, David; Zehr, Kenton; Mamas, Mamas A.; Alraies, M. Chadi
Authors
Yasser Al-Khadra
Tanveer Mir
Fahed Darmoch
Homam M. Pacha
Yasar Sattar
Nketchi Ijioma
Mohamed O. Mohamed
Chun S. Kwok
Abedelrahim I. Asfour
Samir Kapadia
David Rizik
Kenton Zehr
Mamas Mamas m.mamas@keele.ac.uk
M. Chadi Alraies
Abstract
AIM: We sought to determine the racial and ethnical disparities in the delivery of TAVR and to evaluate the in-hospital outcomes and utilization of TAVR stratified by patient ethnicity. METHOD: Using a national inpatient sample database between 2011 and 2015, we identified all adult patients who had TAVR. Races were identified and white race was set as control. Multiple logistic regression analysis was performed for the primary outcome of in-hospital mortality. RESULTS: Out of 58?174 patients who underwent TAVR, 50?809 (87.3%) were white, 2327 (4.0%) were black, 2311 (4.0%) were Hispanic, 640 (1.1%) Asian, 105 (0.2%) Native American and 1982 (3.4%) of other ethnicities. We found a statistically significant linear uptrend in the utilization of TAVR in patients of all races between the years 2011 and 2015. White, black, Hispanic and Native American patients had a downward linear trend for mortality during the studied years (P?=?0.005 for all). Black patients had lower in-hospital mortality [2.8 vs. 3.6%, odds ratio (OR)?=?0.62; 95% confidence interval (CI) 0.44, 0.81 P?<?0.001] compared with white patients, whereas Hispanic patients and Native Americans had higher in-hospital mortality compared with white patients (4.5% OR 1.26; 95% CI 1.01, 1.56 P?=?0.041), (9.5% OR 4.44; 95% CI 2.25, 8.77 P?<?0.001), respectively. CONCLUSION: Overall, TAVR utilization is associated with lower mortality. There is a rising trend in utilization of TAVR in the black population with a significantly favorable mortality trend compared with the white population.
| Acceptance Date | Jan 31, 2021 |
|---|---|
| Publication Date | Jul 1, 2021 |
| Journal | J Cardiovasc Med (Hagerstown) |
| Pages | 586 - 593 |
| DOI | https://doi.org/10.2459/JCM.0000000000001172 |
| Keywords | mortality; race; transcatheter aortic valve replacement |