sex difference and outcome trends following surgical aortic valve replacement from the National inpatient sample (Nis) database

Gabby Elbaz-Greener, Eldad Rahamim, Zahi a.Bu Ghosh, Naseem shadafNy, Ronny alCalai, Amit KoraCh, Shemy Carasso, harindra C. WiJeysuNdera, Tomas Igor, Offer aMir, Guy Rozen, David PlaNer

Research output: Contribution to journalArticlepeer-review

Abstract

BaCKgrouNd: Based on worldwide registries, approximately 50% of patients who underwent aortic valve replacement (aVr) via surgical aortic valve replacement are females. although aVr procedures have improved greatly in recent years, differences in outcome including mortality between sexes remain. We aimed to investigate the trends in saVr outcomes in females versus males. METHODS: Using the 2011-2017 National Inpatient Sample (NIS) database, we identified hospitalizations for patients with diagnosis of aortic stenosis during which saVr was performed. Patients’ sociodemographic and clinical characteristics, procedure complications, and mortality were analyzed. Piecewise regression analyses were performed to assess temporal trends in saVr utilization in females versus males. Multivariable analyses were performed to identify predictors of in-hospital mortality. resulTs: a total of 392,087 hospitalizations for saVr across the usa were analyzed. utilization of saVr in both sex patients decreased significantly during the years 2011-2017. Males compared to females had significantly higher rates of hyperlipidemia, chronic renal disease, peripheral artery disease, coronary artery disease and tended to be smokers. differences in mortality rates among sexes were observed for saVr procedures. Women had higher in-hospital mortality with 3.7% compared to men with 2.5% (or 1.38 [95% Ci 1.33-1.43, P<0.001]). in a multivariable regression model analysis adjusted for potential confounders, women had higher mortality risk with odd ratio (or 1.38 [95% CI 1.33-1.43], P<0.001). Women had significantly higher rates of vascular complications (5.1% compared to men with 4.6%, P=0.002). CoNClusioNs: utilization of saVr showed a downward trend during the study period. higher in-hospital mortality was recorded in females compared to males. (Cite this article as: elbaz-greener g, rahamim e, abu ghosh Z, shadafny N, alcalai r, Korach a, et al. sex difference and outcome trends following surgical aortic valve replacement from the National inpatient sample (Nis) database. J Cardiovasc surg 2024;65:161-8. doi: 10.23736/ s0021-9509.23.12729-7)

Original languageEnglish
Pages (from-to)161-168
Number of pages8
JournalJournal of Cardiovascular Surgery
Volume65
Issue number2
DOIs
StatePublished - Apr 2024

Bibliographical note

Publisher Copyright:
© 2024 Edizioni Minerva Medica. All rights reserved.

Keywords

  • Morbidity
  • Mortality
  • Transcatheter aortic valve replacement

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