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Modifiable Predictors of In-Hospital Mortality in Patients Undergoing Transcatheter Aortic Valve Replacement.

Oluwaseun A Akinseye1, Muhammad Shahreyar1, Chioma C Nwagbara1

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The American Journal of the Medical Sciences
|September 17, 2018
PubMed
Summary

Fluid and electrolyte disorders are modifiable predictors of in-hospital mortality after transcatheter aortic valve replacement (TAVR). Managing these imbalances may improve patient outcomes following TAVR procedures.

Keywords:
In-hospital mortalityNational Inpatient SampleRisk factorsSevere aortic stenosisTranscatheter aortic valve replacement

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Health Outcomes Research

Background:

  • Transcatheter aortic valve replacement (TAVR) is a key therapy for severe aortic stenosis in high-risk patients.
  • Accurate risk prediction models for in-hospital mortality post-TAVR are crucial for patient management.
  • Identifying modifiable risk factors is essential for improving TAVR outcomes.

Purpose of the Study:

  • To identify modifiable risk factors associated with in-hospital mortality after transcatheter aortic valve replacement (TAVR).

Main Methods:

  • Analysis of the 2012 National Inpatient Sample database for patients undergoing TAVR.
  • Comparison of patients who died during hospitalization versus those discharged.
  • Multivariate logistic regression to determine predictors of in-hospital mortality.

Main Results:

  • Fluid and electrolyte disorders emerged as the sole significant positive predictor of in-hospital mortality (OR=1.89, P=0.019).
  • Hypertension was identified as a negative predictor, reducing the odds of in-hospital mortality (OR=0.45, P=0.004).
  • In unadjusted analysis, comorbidities like CHF, coagulopathy, and weight loss were also associated with mortality.

Conclusions:

  • Fluid and electrolyte disturbances are potentially modifiable predictors of in-hospital mortality after TAVR.
  • Interventions aimed at preventing or managing fluid and electrolyte imbalances may enhance patient survival post-TAVR.