P6029Impact of elixhauser comorbidity score on the outcomes of transcatheter aortic valve replacement

Nagaraja, V; Generaeux, P; Cohen, M; Suh, W; Alasnag, M; Potts, J; Gunning, M; Nolan, J; Bagur, R; Mamas, M; Research Group, Keele Cardiovascular

Abstract

Background: Patients undergoing transcatheter aortic valve replacement (TAVR) are often multi-morbid. Whilst the impact of individual comorbid conditions on clinical outcomes following TAVR have been previously assessed, the impact of more global measures of comorbidity burden remains unknown in this cohort.

Objective: To explore the relationship between comorbidity burden and mortality, peri-procedural complications, length of stay and healthcare costs in individuals undergoing TAVR in the National Inpatient Sample (NIS).

Methods: TAVR procedures were identified between 2011 and 2014 and comorbidities were defined by Elixhauser classification system (EC) consisting of 30 comorbidity measures. Endpoints included in-hospital mortality, peri-procedural complications, length of stay and cost. Patients were classified based on their Elixhouser score (ECS) into five categories (ECS I<0, ECS II=0, ECS III=1–5, ECS IV=6–13, ECS V ≥14).

Results: 40,604 TAVR patients were identified and the mean age of patients was 81.2±8.5 years (mean, SD). Patients with the greatest comorbid burden (ECS category V) accounted for more than 40% of the cohort and experienced more than a two-fold increase in hospital mortality [odds ratio (OR): 2.47, 95% confidence interval (CI):1.30–4.69], increased risk of acute kidney injury (OR: 6.72, 95% CI: 4.38–10.32), major bleeding (OR: 2.15, 95% CI: 1.62–2.85) and Stroke and TIA (OR: 2.05, 95% CI: 1.10–3.80). It was also associated with a mean 4.24-day increased length of stay (95% CI: 3.72 - 4.76) and a further $55,000 mean healthcare costs (95% CI: 42,000$-68,000$) compared to patients with lower comorbidities undergoing TAVR after adjusting for confounding factors.

Citation

Nagaraja, V., Generaeux, P., Cohen, M., Suh, W., Alasnag, M., Potts, J., …Research Group, K. C. (2018). P6029Impact of elixhauser comorbidity score on the outcomes of transcatheter aortic valve replacement. European Heart Journal, 39(suppl_1), https://doi.org/10.1093/eurheartj/ehy566.p6029

• Journal Article Type: Article
• Online Publication Date: Aug 28, 2018
• Publication Date: Aug 1, 2018
• Deposit Date: Jun 23, 2023
• Journal: European Heart Journal
• Print ISSN: 0195-668X
• Electronic ISSN: 1522-9645
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 39
• Issue: suppl_1
• DOI: https://doi.org/10.1093/eurheartj/ehy566.p6029
• Keywords: Cardiology and Cardiovascular Medicine