TY - JOUR
T1 - Sex-stratified analysis of national trends and outcomes in isolated tricuspid valve surgery
AU - Chandrashekar, Pranav
AU - Fender, Erin Amanda
AU - Zack, Chad J.
AU - Reddy, Yogesh N.V.
AU - Bennett, Courtney E.
AU - Prasad, Megha
AU - Al-Hijji, Mohammed A.
AU - Stulak, John M.
AU - Miller, Virginia M.
N1 - Funding Information:
Data were obtained from the Agency for Healthcare and Research and Quality Healthcare Cost and Utilization Project NIS files from 1 January 2004 to 31 December 2013. The NIS is the largest publicly available all-payer administrative claims database. It contains deidenti-fied patient and clinical data from approximately 1000 non-federal hospitals in 45 states, including approximately 5–8 million discharges annually. These data represent roughly 20% of hospital admissions in the USA and the collection of data is stratified to ensure equal representation of hospitals by geographic region, urban and rural locations, teaching status and hospital bed size. Data can be weighted such that the results can be extrapolated as representative of the entire US inpatient population. Procedure and diagnostic codes are recorded using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). This study was exempt from Institutional Review Board evaluation and was supported in part by grants from the National Institutes of Health (National Center for Advancing Translational Sciences grant numbers UL1 TR000135 and P50 AG044170 to VMM).
Funding Information:
Funding This publication was made possible by NIH P50 AG044170 and by CTSA (grant number UL1 TR000135) from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH.
Publisher Copyright:
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018.
PY - 2018/2
Y1 - 2018/2
N2 - Objective: Female sex is a known risk factor for cardiac surgery, and tricuspid valve (TV) disease is more common in women. There are few data on sex-stratified surgical outcomes for isolated TV surgery. An administrative database was used to compare acute in-hospital outcomes between men and women undergoing isolated TV surgery. Methods: Patients aged >18 who underwent TV repair or replacement from 2004 to 2013 were identified using the National Inpatient Sample. Patients were excluded if they had congenital heart disease, endocarditis, or were undergoing concomitant cardiac surgeries except coronary bypass. Results were weighted to represent national averages. Sex-stratified analysis was performed using propensity score matching to compare in-hospital mortality, postoperative complications and hospital costs. Results: Over 10 years, women represented 58% of the 5005 TV surgeries performed. With propensity matching, hospital mortality (7.9% vs 7.7%; P=0.99) and median length of stay (11 vs 11 days; P=0.99) were similar between men and women. However, median hospital charges were higher for men ($166 000 vs $155 000; P=0.04). Conclusion: Isolated TV surgery is rare, but women more commonly undergo the procedure. In-hospital mortality was similar between men and women after propensity matching, but remains markedly high for both men and women in comparison to that reported for left-sided isolated valve surgery.
AB - Objective: Female sex is a known risk factor for cardiac surgery, and tricuspid valve (TV) disease is more common in women. There are few data on sex-stratified surgical outcomes for isolated TV surgery. An administrative database was used to compare acute in-hospital outcomes between men and women undergoing isolated TV surgery. Methods: Patients aged >18 who underwent TV repair or replacement from 2004 to 2013 were identified using the National Inpatient Sample. Patients were excluded if they had congenital heart disease, endocarditis, or were undergoing concomitant cardiac surgeries except coronary bypass. Results were weighted to represent national averages. Sex-stratified analysis was performed using propensity score matching to compare in-hospital mortality, postoperative complications and hospital costs. Results: Over 10 years, women represented 58% of the 5005 TV surgeries performed. With propensity matching, hospital mortality (7.9% vs 7.7%; P=0.99) and median length of stay (11 vs 11 days; P=0.99) were similar between men and women. However, median hospital charges were higher for men ($166 000 vs $155 000; P=0.04). Conclusion: Isolated TV surgery is rare, but women more commonly undergo the procedure. In-hospital mortality was similar between men and women after propensity matching, but remains markedly high for both men and women in comparison to that reported for left-sided isolated valve surgery.
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U2 - 10.1136/openhrt-2017-000719
DO - 10.1136/openhrt-2017-000719
M3 - Article
C2 - 29344380
AN - SCOPUS:85041698790
SN - 2053-3624
VL - 5
JO - Open Heart
JF - Open Heart
IS - 1
M1 - e000719
ER -