Effect of Hospital Volume on Outcomes of Transcatheter Mitral Valve Repair: An Early US Experience

Nileshkumar J Patel; Apurva O Badheka; Sunny Jhamnani; Sidakpal S Panaich; Vikas Singh; Nilay Patel; Shilpkumar Arora; Cindy L Grines; Micheal Cleman; John K Forrest

doi:10.1111/joic.12228

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Effect of Hospital Volume on Outcomes of Transcatheter Mitral Valve Repair: An Early US Experience

Journal article

Open access

Peer reviewed

Effect of Hospital Volume on Outcomes of Transcatheter Mitral Valve Repair: An Early US Experience

Nileshkumar J Patel, Apurva O Badheka, Sunny Jhamnani, Sidakpal S Panaich, Vikas Singh, Nilay Patel, Shilpkumar Arora, Cindy L Grines, Micheal Cleman and John K Forrest

Journal of interventional cardiology, Vol.28(5), pp.464-471

10/2015

DOI: 10.1111/joic.12228

PMID: 26489974

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Abstract

Transcatheter mitral valve repair (TMVR) is a complex procedure for patients with mitral regurgitation who cannot get surgery. However, there is a lack of data on how hospital volumes affect these outcomes. We performed a cross sectional study based on Healthcare Cost and Utilization Project's Nationwide Inpatient Sample database of 2012 and identified subjects using the ICD-9-CM procedure code of 35.97, which was introduced in October 2010 for percutaneous mitral valve repair if present in the primary or secondary procedure field. Hospital volumes were divided into tertiles. The primary outcome was a composite of in-hospital mortality and peri-procedural complications. Length of stay and hospitalization cost were also assessed. A total of 95 (weighted n = 475) TMVR procedures were identified. The mean age of the overall cohort was 70 years; 43.2% were female and 63.2% had a significant baseline burden of co-morbidities. The composite of in-hospital mortality and peri-procedural complications decreased with increasing TMVR hospital volume: 48.7% in the first tertile, 17.4% in the second tertile, and 9.1% in the third tertile. Additionally, we saw a decrease in the length of stay and a trend in decrease in the hospitalization cost. In hospitals performing TMVR, higher hospital volumes are associated with a reduction in a composite of in-hospital mortality and post-procedural complications, in addition to the shorter length of stay.

United States

Hospital Costs

Postoperative Complications - economics

Hospitals - standards

Cross-Sectional Studies

Hospital Mortality

Length of Stay - economics

Mitral Valve Insufficiency - surgery

Outcome Assessment (Health Care)

Humans

Male

Mitral Valve Annuloplasty - mortality

Mitral Valve Annuloplasty - economics

Hospitals - classification

Quality Improvement

Cardiac Catheterization - methods

Female

Aged

Length of Stay - statistics & numerical data

Mitral Valve Annuloplasty - adverse effects

Mitral Valve Annuloplasty - methods

Databases, Factual

Details

Title: Subtitle: Effect of Hospital Volume on Outcomes of Transcatheter Mitral Valve Repair: An Early US Experience
Creators: Nileshkumar J Patel - Staten Island University Hospital, Staten Island, New York
Apurva O Badheka - Yale School of Medicine, New Haven, Connecticut
Sunny Jhamnani - Yale School of Medicine, New Haven, Connecticut
Sidakpal S Panaich - Detroit Medical Center, Detroit, Michigan
Vikas Singh - University of Miami Miller School of Medicine, Miami, Florida
Nilay Patel - Saint Peter's University Hospital, New Brunswick, New Jersey
Shilpkumar Arora - Mount Sinai St. Luke's Roosevelt Hospital, New York
Cindy L Grines - Detroit Medical Center, Detroit, Michigan
Micheal Cleman - Yale School of Medicine, New Haven, Connecticut
John K Forrest - Yale School of Medicine, New Haven, Connecticut
Resource Type: Journal article
Publication Details: Journal of interventional cardiology, Vol.28(5), pp.464-471
DOI: 10.1111/joic.12228
PMID: 26489974
NLM abbreviation: J Interv Cardiol
ISSN: 0896-4327
eISSN: 1540-8183
Language: English
Date published: 10/2015
Academic Unit: Cardiovascular Medicine; Internal Medicine
Record Identifier: 9984094214902771

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