Impact of complications on outcomes following aortic and mitral valve replacements in the United States

V Allareddy; M M Ward; J W Ely; J Levett

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Impact of complications on outcomes following aortic and mitral valve replacements in the United States

Journal article

Peer reviewed

Impact of complications on outcomes following aortic and mitral valve replacements in the United States

V Allareddy, M M Ward, J W Ely, V Allareddy and J Levett

Journal of cardiovascular surgery, Vol.48(3), pp.349-357

06/2007

PMID: 17505440

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Abstract

Heart valve replacement surgeries account for 20% of all cardiac procedures. In-hospital mortality rates are approximately 6% for aortic valve replacements and 10% for mitral valve replacements. The objectives of the study are to provide nationally representative estimates of complications following aortic and mitral valve replacements and to quantify the impact of different types of complications on in-hospital outcomes. The Nationwide Inpatient Sample was analyzed for years 2000-2003. The effect of complications on in-hospital mortality, length of stay (LOS), and hospital charges were examined using bivariate and multivariable logistic and linear regression analyses. The confounding effects of age, sex, primary diagnosis, type of valve replacement, type of admission, comorbid conditions, and hospital characteristics were adjusted. A total of 43,909 patients underwent aortic valve replacement as the primary procedure during the study period and 16,516 patients underwent mitral valve replacement. Complications occurred in 35.2% of those undergoing aortic valve replacements and in 36.4% of those undergoing mitral valve replacements. Almost half of these are cardiac complications and a quarter involve hemorrhage/hematoma/seroma. Complications were significantly associated with in-hospital mortality, LOS, and hospital charges even after adjusting for patient and hospital characteristics. Complications are prevalent and exert a considerable influence on outcomes following aortic and mitral valve replacements. Quality initiatives should focus on minimizing complications and improving processes of care that would enable complications to be better resolved if they occur.

Hospital Costs

United States - epidemiology

Prevalence

Humans

Middle Aged

Male

Mitral Valve - surgery

Heart Valve Diseases - surgery

Aortic Valve - surgery

Heart Valve Diseases - economics

Heart Valve Diseases - mortality

Female

Length of Stay

Hospital Mortality

Risk Assessment

Heart Valve Prosthesis Implantation - economics

Risk Factors

Linear Models

Logistic Models

Treatment Outcome

Heart Diseases - economics

Heart Valve Prosthesis Implantation - statistics & numerical data

Heart Diseases - etiology

Heart Diseases - mortality

Heart Valve Prosthesis Implantation - adverse effects

Aged

Population Surveillance

Details

Title: Subtitle: Impact of complications on outcomes following aortic and mitral valve replacements in the United States
Creators: V Allareddy - Department of Health Management and Policy, College of Public Health, The University of Iowa, E107 General Hospital, Iowa City, IA 52242-1008, USA
M M Ward
J W Ely
V Allareddy
J Levett
Resource Type: Journal article
Publication Details: Journal of cardiovascular surgery, Vol.48(3), pp.349-357
Publisher: Italy
PMID: 17505440
ISSN: 0021-9509
eISSN: 1827-191X
Grant note: HS015009 / AHRQ HHS
Language: English
Date published: 06/2007
Academic Unit: Health Management and Policy; Family and Community Medicine
Record Identifier: 9984065714002771

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3 Times Cited - Web of Science