The Impact of Cardiac Damage on In-Hospital Outcomes for Patients With Aortic Stenosis in the United States: An Analysis From The National Inpatient Sample
ABSTRACT
Introduction
The objective of this study is to determine if cardiac damage based on hospital discharge codes is associated with in-hospital outcomes in patients with aortic stenosis (AS).
Methods
We conducted a retrospective cohort study of hospital admissions between 2016 and 2021 with a diagnosis of AS in the National Inpatient Sample (NIS). The cardiac damage stages 0−4 were determined based on hospital discharge codes. Logistic and linear regressions were used to determine the association between cardiac stage and in-hospital mortality, length of stay (LoS) and cost.
Results
A total of 2,980,150 hospital admissions were included in the analysis (82.5% conservative management, 11.2% transcatheter aortic valve replacement [TAVR], 6.3% surgical aortic valve replacement [SAVR]). The association between cardiac damage stage and in-hospital outcome was most significant for patients who had SAVR treatment (stage 4 vs. stage 0: mortality OR 27.70 95% CI 17.35−35.17, LoS 7.34 95% CI 6.34−8.35, cost 70,710 95% CI 65,110−76,310) compared to TAVR treatment (stage 4 vs. stage 0: mortality OR 9.15 95% CI 5.52−15.15, LoS 6.27 95% CI 5.63−6.90, cost 28,384 25,084 to 31,684) and conservative treatment (stage 4 vs. stage 0: mortality OR 3.55 95% CI 3.13−4.04, LoS 2.09 95% CI 1.87 to 2.31, cost 6362 95% CI 5642−7083).
Conclusions
Cardiac damage can be evaluated using diagnostic codes in patients with AS and it is associated with in-hospital mortality, LoS and cost, and has more impact on these outcomes in patients treated with SAVR versus those treated with TAVR.
Conflicts of Interest
The authors have no conflicts of interest.
Open Research
Data Availability Statement
The data that support the findings of this study are available from Healthcare Cost and Utilization Project. Restrictions apply to the availability of these data, which were used under license for this study. Data are available from https://hcup-us.ahrq.gov/nisoverview.jsp with the permission of Healthcare Cost and Utilization Project.
The authors do not have permission to share the data but the data can be obtained from the Healthcare Cost and Utilization Project website.
