Author + information
- Fahad Alqahtani,
- Sami Aljohani,
- Ahmed Almustafa,
- Ashwin Bhirud,
- Khaled Boobes,
- Chalak Berzingi,
- Sameer Raina,
- Wissam Gharib and
- Mohamad Alkhouli
Background: Hemodialysis (HD) patients with aortic stenosis are less likely to undergo aortic valve replacement (AVR) due to their excess perioperative mortality. We aim to evaluate the utilization trends and outcomes of AVR in the U.S using a nationwide database.
Methods: We used the Nationwide Inpatient Sample to identify 138,092 patients who underwent isolated AVR between 2004-2013, of whom 4479 (3.2%) were on HD. Trends of volume and mortality were assessed. Multivariable logistic regression derived propensity scores were matched 1:1 to attain 4402 pairs of HD vs. non-HD patients to assess in-hospital outcomes and cost.
Results: The utilization of AVR in HD patients increased significantly between 2004 to 2013 (p=0.005), with no significant change in in-hospital mortality overtime (p=0.530). Patients on HD had 4-folds higher mortality rates than those not on HD (24.6 % vs 6.4 % p= <0.001). HD patients also had higher rates of vascular complications (10.5 % vs 8.2 %, p<0.001), and stroke (6.6 % vs 3.8 %, p<0.001). Hospital length of stay and total charges were significantly higher in the HD group (23±19 vs 13.2±13 days, P<0.001, and 334024±263353$ vs. 205377±182037$, p<0.001, respectively).
Conclusions: Despite the increasing utilization of AVR, perioperative mortality and cost of care in HD patients remained substantial in contemporary U.S practice. Further studies are needed to assess the role of transcatheter valve replacement in improving outcomes and reducing cost of care in HD patients.
Moderated Poster Contributions
Valvular Heart Disease Moderated Poster Theater, Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-3:55 p.m.
Session Title: Valvular Heart Disease With CKD or Cirrhosis
Abstract Category: 36. Valvular Heart Disease: Clinical
Presentation Number: 1172M-03
- 2017 American College of Cardiology Foundation