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Outcomes after aortic and mitral valve replacement surgery in Canada: 1994/95 to 1999/2000

Ansar Hassan1, Hude Quan, Alice Newman

  • 1Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.

The Canadian Journal of Cardiology
|March 11, 2004
PubMed

Insights

In-hospital mortality rates for valve surgery in Canada remained stable between 1994/95 and 1999/2000. However, significant differences in outcomes were observed across Canadian provinces for aortic valve replacement and mitral valve replacement procedures.

Area of Science:

  • Cardiovascular Surgery
  • Health Services Research
  • Public Health

Background:

  • Limited scope of previous Canadian valve surgery outcome studies.
  • Need for comprehensive, national data on valve surgery outcomes.
  • Utilizing administrative data for large-scale health outcome analysis.

Purpose of the Study:

  • To report observed and risk-adjusted in-hospital mortality rates for aortic valve replacement (AVR) and mitral valve replacement (MVR) in Canada.
  • To analyze trends from 1994/95 to 1999/2000.
  • To identify interprovincial variations in outcomes.

Main Methods:

  • Analysis of hospital discharge abstract data from the Canadian Institute for Health Information (CIHI).
  • Inclusion of all AVR and MVR cases (1994/95-1999/2000), with or without concomitant coronary artery bypass grafting (CABG).
  • Risk adjustment using logistic regression for sociodemographic, comorbidity, and disease-specific factors.

Main Results:

  • Overall in-hospital mortality: 3.7% for isolated AVR, 5.7% for isolated MVR (excluding Quebec).
  • Stable risk-adjusted in-hospital mortality rates observed annually.
  • Significant interprovincial variation in mortality rates for both AVR (2.6%-6.8%) and MVR (2.5%-13.0%).

Conclusions:

  • In-hospital mortality following valve surgery in Canada has remained consistent over the study period.
  • Substantial provincial disparities in valve surgery outcomes exist.
  • This study offers the first extensive national overview of Canadian valve surgery outcomes.
Abstract

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