Predictors of in-hospital mortality in patients with end-stage renal disease undergoing transcatheter aortic valve replacement: A nationwide inpatient sample database analysis
Document Type
Article
Department
Cardiology; Office of the Provost
Abstract
Background: Patients with end-stage renal disease (ESRD) were excluded from all major trials on the safety of transcatheter aortic valve replacement (TAVR). This study aims to identify the predictors of mortality due to the rising rate of TAVR utilization and subsequent mortality in patients with ESRD.
Methods: The National Inpatient Sample (NIS) (2002-2017) was queried to identify all patients with ESRD undergoing TAVR. The trend of all-cause mortality and its predictors were determined using a binary logistic regression model to obtain adjusted odds ratios (aOR).
Results: A total of 6836 patients (6341 survived, 495 died) were included in the analysis. The proportion of demographic and baseline comorbidities for survived vs. non-survived was nearly identical between the two groups. A rising trend in the utilization and mortality of TAVR in ESRD was noted. The adjusted odds of mortality was significantly higher for hypertension (6.92, 95% CI 3.78-12.66, p ≤ 0.0001), liver disease (4.51, 955 CI 3.30-6.17, p ≤ 0.0001), drug abuse (aOR 34.88, 95% CI 12.79-95.13, p ≤ 0.0001), periprocedural pneumonia (aOR 2.80, 95% CI 1.98-3.96, p ≤ 0.0001), cardiogenic shock (aOR, 5.97, 95% CI 4.63-7.70, p ≤ 0.0001), ST-elevation myocardial infarction (aOR 5.13, 95% CI 2.29-11.49, p ≤ 0.0001) and third-degree heart block (aOR 1.47, 955 CI 1.10-1.97, p0.01) in patients with ESRD undergoing TAVR. The mean length of stay and mean number of diagnoses recorded were also significantly higher for non-surviving TAVR patients.
Conclusion: Baseline hypertension, liver disease, third-degree heart block, periprocedural pneumonia, cardiogenic shock and STEMI can significantly increase the in-hospital mortality rate in ESRD patients undergoing TAVR.
Publication (Name of Journal)
Cardiovascular Revascularization Medicine
DOI
10.1016/j.carrev.2021.02.002
Recommended Citation
Ullah, W.,
Jafar, M.,
Zahid, S.,
Ahmed, F.,
Khan, M. Z.,
Sattar, Y.,
Fischman, D. L.,
Virani, S. S.,
Alam, M.
(2022). Predictors of in-hospital mortality in patients with end-stage renal disease undergoing transcatheter aortic valve replacement: A nationwide inpatient sample database analysis. Cardiovascular Revascularization Medicine, 34, 63-68.
Available at:
https://ecommons.aku.edu/provost_office/549
Comments
Pagination is not provided by the author/publisher. This work was published before the author joined Aga Khan University.