Table 1. Baseline Characteristics and Outcomes of Patients Undergoing Transcatheter Aortic Valve Replacement (TAVR), Based on Quartiles of Risk-Standardized Surgical Aortic Valve Replacement Mortality Rates in the Pre-TAVR Period per Risk-Adjusted Mortality Ratesa.
| Characteristic | Patients Undergoing TAVR Procedure, No. (%) | P Value | |||
|---|---|---|---|---|---|
| Quartile 1 (n = 19 798) | Quartile 2 (n = 7663) | Quartile 3 (n = 10 180) | Quartile 4 (n = 14 283) | ||
| Baseline | |||||
| Age, mean (SD), y | 82.6 (8.1) | 82.3 (7.8) | 82.5 (7.9) | 82.2 (8.0) | <.001 |
| Female | 9476 (47.9) | 3697 (48.4) | 4843 (47.7) | 6926 (48.5) | .50 |
| Congestive heart failure | 15 233 (77.0) | 5668 (74.2) | 7653 (75.3) | 10 838 (76.0) | <.001 |
| Cardiac arrhythmias | 13 355 (67.5) | 5003 (65.5) | 6638 (65.3) | 9406 (65.9) | <.001 |
| Pulmonary circulation disorders | 4860 (24.6) | 1777 (23.3) | 2281 (22.5) | 3353 (23.5) | <.001 |
| Peripheral vascular disorders | 6069 (30.7) | 2249 (29.4) | 2835 (27.9) | 3862 (27.1) | <.001 |
| Hypertension, uncomplicated | 9303 (47.1) | 3763 (49.3) | 5013 (49.3) | 6724 (47.1) | <.001 |
| Hypertension, complicated | 7593 (38.4) | 2857 (37.4) | 3649 (35.9) | 5485 (38.4) | <.001 |
| Paralysis | 198 (1.0) | 75 (1.0) | 107 (1.1) | 151 (1.1) | .92 |
| Other neurological disorders | 1087 (5.5) | 417 (5.5) | 646 (6.4) | 839 (5.9) | .01 |
| Chronic pulmonary disease | 9604 (48.6) | 3624 (47.4) | 4831 (47.5) | 6755 (47.3) | .09 |
| Diabetes, uncomplicated | 5606 (28.4) | 2327 (30.5) | 3099 (30.5) | 4508 (31.6) | <.001 |
| Diabetes, complicated | 1420 (7.2) | 488 (6.4) | 601 (5.9) | 800 (5.6) | <.001 |
| Hypothyroidism | 4419 (22.4) | 1706 (22.3) | 2236 (22.0) | 3109 (21.8) | .62 |
| Renal failure | 8046 (40.7) | 3026 (39.6) | 3829 (37.7) | 5748 (40.3) | <.001 |
| Liver disease | 649 (3.3) | 251 (3.3) | 293 (2.9) | 423 (3.0) | .14 |
| Peptic ulcer disease, excluding bleeding | 160 (0.8) | 66 (0.9) | 83 (0.8) | 124 (0.9) | .92 |
| AIDS | 11 (0.1) | 0 (0.0) | 0 (0.0) | 1 (<1) | .002 |
| Lymphoma | 297 (1.5) | 80 (1.0) | 136 (1.3) | 174 (1.2) | .02 |
| Metastatic cancer | 94 (0.5) | 32 (0.4) | 45 (0.4) | 84 (0.6) | .24 |
| Solid tumor without metastasis | 445 (2.3) | 147 (1.9) | 214 (2.1) | 325 (2.3) | .30 |
| Rheumatoid arthritis/collagen vascular | 1090 (5.5) | 425 (5.6) | 518 (5.1) | 691 (4.8) | .02 |
| Coagulopathy | 3973 (20.1) | 1729 (22.6) | 2356 (23.2) | 3132 (21.9) | <.001 |
| Obesity | 3136 (15.9) | 1204 (15.8) | 1410 (13.9) | 2035 (14.3) | <.001 |
| Weight loss | 1238 (6.3) | 299 (3.9) | 508 (5.0) | 668 (4.7) | <.001 |
| Fluid and electrolyte disorders | 4961 (25.1) | 2018 (26.4) | 2756 (27.1) | 3598 (25.2) | <.001 |
| Blood loss anemia | 225 (1.1) | 129 (1.7) | 149 (1.5) | 220 (1.5) | <.001 |
| Deficiency anemia | 691 (3.5) | 313 (4.1) | 403 (4.0) | 527 (3.7) | .06 |
| Alcohol abuse | 85 (0.4) | 49 (0.6) | 45 (0.4) | 71 (0.5) | .14 |
| Drug abuse | 27 (0.1) | 24 (0.3) | 15 (0.1) | 27 (0.2) | .02 |
| Psychoses | 164 (0.8) | 80 (1.0) | 103 (1.0) | 150 (1.1) | .13 |
| Depression | 1608 (8.1) | 730 (9.6) | 750 (7.4) | 1125 (7.9) | <.001 |
| Elixhauser Comorbidity Index, mean (SD) | 6.4 (2.0) | 6.3 (2.0) | 6.2 (2.0) | 6.2 (2.0) | <.001 |
| TAVR volume, median (IQR) | 281 (163-481) | 123 (73-197) | 206 (107-402) | 209 (142-339) | <.001 |
| Transapical access | 3045 (15.4) | 1461 (19.1) | 1491 (14.7) | 1952 (13.7) | <.001 |
| Hospital stay length, days, median (IQR) | 5 (3-8) | 5 (4-8) | 5 (3-9) | 5 (3-8) | .66 |
| Observed mortality | |||||
| 30 d | 917 (4.6) | 381 (5.0) | 521 (5.1) | 800 (5.6) | <.001 |
| 1 y | 3359 (17.0) | 1337 (17.5) | 1852 (18.2) | 2652 (18.6) | <.001 |
Abbreviations: IQR, interquartile range; TAVR, transcatheter aortic valve replacement.
a
Each quartile contained 130 hospitals, with the exception of quartile 4, which had 129 hospitals. Quartile 1 had the lowest SAVR mortality rate; quartile 4 had the highest.