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Related Experiment Videos

Mortality after aortic valve replacement: results from a nationally representative database.

B C Astor1, R G Kaczmarek, B Hefflin

  • 1Center for Devices and Radiological Health, Food and Drug Administration, Rockville, Maryland, USA. bastor@jhsph.edu

The Annals of Thoracic Surgery
|January 13, 2001
PubMed
Summary

Nationally representative estimates show that aortic valve replacement in-hospital mortality rates are similar to The Society of Thoracic Surgeons database. Higher hospital procedure volume is linked to lower mortality.

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Area of Science:

  • Cardiovascular Surgery
  • Health Services Research

Background:

  • Nationally representative estimates for in-hospital mortality after aortic valve replacement (AVR) are needed.
  • This is crucial for assessing the generalizability of The Society of Thoracic Surgeons National Cardiac Surgery Database (STS NCSD) results to other US institutions.

Purpose of the Study:

  • To estimate patient characteristics and in-hospital mortality rates for AVR in US nonfederal hospitals.
  • To examine procedural and hospital factors associated with in-hospital mortality.

Main Methods:

  • Utilized data from the 1994 Nationwide Inpatient Sample (NIS).
  • Analyzed an estimated 46,397 AVR procedures performed in nonfederal hospitals.
  • Examined associations between hospital/procedural characteristics and mortality.

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Main Results:

  • Overall in-hospital mortality was 6.4%; 4.3% for first-time isolated AVR.
  • Higher procedure-specific hospital volume was associated with reduced in-hospital mortality (aOR 0.58; 95% CI 0.42-0.81).

Conclusions:

  • Observed in-hospital mortality rates closely mirror those reported by the STS NCSD.
  • Findings support the representativeness of STS NCSD data for other institutions.
  • Procedure-specific hospital volume is a critical factor when interpreting AVR outcomes for individual hospitals.