Cardiovascular Outcomes of Frailty in Surgical Aortic Valve Replacement and Its Impact on Readmissions: A Nationwide Readmission Analysis
Author Type(s)
Resident/Fellow
Document Type
Abstract
Publication Date
2022
DOI
10.1016/j.jacc.2022.08.532
Journal Title
Journal of the American College of Cardiology
Department
Medicine
Abstract
Background: Surgical aortic valve replacement (SAVR) is done very frequently for aortic pathology, and the impact of surgical thoracic risk is well documented, but the impact of frailty score is limited in the literature. Methods: We queried the Nationwide Readmissions Database (2017-2019) using International Classification of Diseases-Ninth Revision-Clinical Modification codes for SAVR and frailty score. We categorized frailty score into a high frailty score (HFS; score >3) and a low to intermediate frailty score (LIFS; score <3). Results: A total of 21,9243 patients were included in our study (HFS = 89.2%; LIFS = 10.7%). The median age of HFS and LIFS was 65 and 62 years, respectively. The mean length of stay for HFS and LIFS was 11 and 6 days. Baseline demographic characteristics and comorbidities of study population are shown in Figure 1. The HFS have higher in-hospital mortality (OR: 4.5), acute kidney injury (AKI) (OR: 192), heart failure (OR: 1.9), myocardial infarction (OR: 3.1), sudden cardiac arrest (OR: 1.7), mechanical circulatory support requirement (OR: 3.8), major bleeding (OR: 4.7), and major adverse cardiovascular and cerebrovascular events (OR: 4.5). The most common complications were AKI, heart failure, major adverse cardiovascular and cerebrovascular events, net adverse event, and transfusion in HFS. HFS have higher 30-day, 90-day, and 180-day readmissions compared with LIFS. [Formula presented] Conclusion: Patients with an HFS have worse cardiovascular outcomes after SAVR with the highest AKI as the leading, most common, high-cost burden and high length of stay, and higher 30-day, 90-day, and 180-day readmissions. HFS has a strong impact on postsurgical stroke. Categories: ENDOVASCULAR: Aortic Disease and Aortic Intervention
Recommended Citation
Sattar, Y., Patel, N., Titus, A., Patel, N., Pandya, K., Khan, M., Alraies, M. C., & Daggubati, R. (2022). Cardiovascular Outcomes of Frailty in Surgical Aortic Valve Replacement and Its Impact on Readmissions: A Nationwide Readmission Analysis. Journal of the American College of Cardiology, 80 (12), B182. https://doi.org/10.1016/j.jacc.2022.08.532
