Author + information
- Siva Sagar Taduru,
- Shubha Deep Roy,
- Madhuri Ramakrishnan,
- Rakesh Ponnapureddy and
- Paramdeep Baweja
Background: Atrial septal anomalies are the most common congenital heart defects in adults. Percutaneous closure is the preferred method of correction of atrial septal defects (ASD). There was a yearly increase in the utilization rates from 2001 to 2008 and a previous study quotes a 4.7-fold increase in utilization. Data on post guideline period is scant.
Methods: We searched the Nationwide Inpatient Sample from 2008 to 2013 using International Classification of Diseases (ICD-9-CM) codes for patients older than 18 years with ASD (745.5) who underwent percutaneous closure of ASD (35.52). Chi square test was used to compare categorical variables. ANOVA was used to compare continuous variables. Multivariate binary logistic regression and multivariate linear regression analyses was performed to identify independent variables associated with in-hospital mortality and length of stay (LOS) respectively.
Results: A total of 3813 percutaneous ASD closures were performed from 2008 to 2013. Utilization of this procedure decreased 3-fold from 13.47/100,000 to 4.49/100,000 from 2008 to 2013 (P <0.0001). In-hospital mortality has not changed significantly (P=0.116). Mean LOS increased from 2.87 days to 4.43 days (P <0.0001). Mean total charges for the hospitalization increased from 58,809$ to 102,741$ (P <0.0001). Comorbidities of coagulopathy, hypothyroidism, electrolyte abnormality and pulmonary circulation disorders were associated with increased mortality (P <0.05). Age and comorbidities of anemia, congestive heart failure, chronic pulmonary disease, coagulopathy, diabetes with chronic complications, liver disorders, renal failure, pulmonary circulation disorders and valvular heart problems were associated with increased LOS.
Conclusions: Utilization of percutaneous ASD closure has decreased by 3-fold since the publication of ACC/AHA guidelines. However, the length of stay has increased which may be related to stricter application of guidelines resulting in patients with higher comorbidity burden. As a result, total charges for hospitalization has increased.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Structural Heart Interventions: Focus on Mitral Valve, Left Atrial Appendage and HOCM
Abstract Category: 24. Interventional Cardiology: Mitral and Structural Heart Disease
Presentation Number: 1156-171
- 2017 American College of Cardiology Foundation