NYMC Faculty Publications
Regional Variation in Utilization, In-hospital Mortality, and Health-care Resource Use of Transcatheter Aortic Valve Implantation in the United States
DOI
10.1016/j.amjcard.2017.07.102
Journal Title
American Journal of Cardiology
First Page
1869
Last Page
1876
Document Type
Article
Publication Date
11-1-2017
Department
Medicine
Abstract
We queried the National Inpatient Sample database from 2012 to 2014 to identify all patients aged >/=18 years undergoing transcatheter aortic valve implantation (TAVI) in the United States. Regional differences in TAVI utilization, in-hospital mortality, and health-care resource use were analyzed. Of 41,025 TAVI procedures in the United States between 2012 and 2014, 10,390 were performed in the Northeast, 9,090 in the Midwest, 14,095 in the South, and 7,450 in the West. Overall, the number of TAVI implants per million adults increased from 24.8 in 2012 to 63.2 in 2014. The utilization of TAVI increased during the study period in all 4 geographic regions, with the number of implants per million adults being highest in the Northeast, followed by the Midwest, South, and West, respectively. Overall in-hospital mortality was 4.2%. Compared with the Northeast, risk-adjusted in-hospital mortality was higher in the Midwest (adjusted odds ratio [aOR] 1.26 [1.07 to 1.48]) and the South (aOR 1.61 [1.40 to 1.85]) and similar in the West (aOR 1.00 [0.84 to 1.18]). Average length of stay was shorter in all other regions compared with the Northeast. Among patients surviving to discharge, disposition to a skilled nursing facility or home health care was most common in the Northeast, whereas home discharge was most common in the West. Average hospital costs were highest in the West. In conclusion, we observed significant regional differences in TAVI utilization, in-hospital mortality, and health-care resource use in the United States. The findings of our study may have important policy implications and should provide an impetus to understand the source of this regional variation.
Recommended Citation
Gupta, T., Kalra, A., Kolte, D., Khera, S., Aronow, W., Panza, J., Bhatt, D., Garcia, M., & Bhatt, D. (2017). Regional Variation in Utilization, In-hospital Mortality, and Health-care Resource Use of Transcatheter Aortic Valve Implantation in the United States. American Journal of Cardiology, 120 (10), 1869-1876. https://doi.org/10.1016/j.amjcard.2017.07.102
Comments
Please see the work itself for the complete list of authors.