Author + information
- Sidakpal Panaich,
- Shilpkumar Arora,
- Elad Maor,
- John Rapheal,
- Nilay Patel,
- Apurva Badheka,
- Abhishek Deshmukh,
- Mackram Eleid,
- Harshil Shah,
- Byomesh Tripathi,
- Ala Asasad,
- Kosha Thakore and
- Charanjit Rihal
Background: The primary objective of our study was to evaluate real-world outcomes of Transcatheter mitral valve repair (MitraClip) in terms of length of stay (LOS) and cost of care.
Methods: The study cohort was derived from the National Readmission Data (NRD) 2013, a subset of the Healthcare Cost and Utilization Project (HCUP) sponsored by the Agency for Healthcare Research and Quality (AHRQ). Transcatheter mitral valve repair (MitraClip) was identified using appropriate International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. Hierarchical two level logistic models were used to evaluate LOS and hospitalization costs.
Results: We identified a total of 274 (weighted n=537) procedures. There were 39 (weighted n=78) (14.2%) short-term readmissions during the study period. The mean LOS during index admission was 8.73±0.72 days. The mean hospitalization costs were $54,895.67±3,403.96 during index admission and $16,280.11±3,472 during readmission. Multivariate predictors (OR, 95% CI, p-value) of increased LOS and hospitalization costs included chronic renal failure (+7.69 days, 5.01-10.38 days, <.0.001) ($30722, $17,221-$44,223, <0.001) and use of hemodynamic support during index admission (6.92 days, 4.20-9.65 days, <0.001) ($43,481, $29244 – 57,718, <0.001). Elective procedures were associated with significantly lower LOS (−8.48 days, −11.07 – −5.89 days, <0.001) and hospitalization costs (−$26,637, −$39,895 – −$13,379, 0.00).
Conclusions: Patients undergoing MitraClip procedure represent a complex population with multiple co-morbidities and carefully planned, elective procedures are likely to result in shorter LOS and hospitalization costs. Contrarily, co-morbidities like chronic renal failure and use of hemodynamic support in this patient population is associated with longer LOS and higher hospitalization costs.
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: 1156-174
- 2017 American College of Cardiology Foundation