Table 2. Outcomes Among Medicare Beneficiaries Undergoing TAVR Procedures at Hospitals With Low and High SAVR or TAVR Volume.
| Characteristic | Procedures Performed in the First Year | Procedures Performed in the First 2 y | Procedures Performed in All Years | |||
|---|---|---|---|---|---|---|
| Events, No./Total No. (%) | Adjusted OR (95% CI) | Events, No./Total No. (%) | Adjusted OR (95% CI) | Events, No./Total No. (%) | Adjusted OR (95% CI) | |
| Patients, No. | 10 962 | 24 442 | 58 337 | |||
| 30-d Mortality | ||||||
| SAVR volume | ||||||
| Low | 450/6526 (6.9) | 1 [Reference] | 866/13924 (6.2) | 1 [Reference] | 1549/28263 (5.5) | 1 [Reference] |
| High | 294/4436 (6.6) | 0.96 (0.78-1.18) | 635/10518 (6.0) | 0.93 (0.80-1.09) | 1447/30074 (4.8) | 0.93 (0.83-1.04) |
| TAVR volume | ||||||
| Low | 369/5385 (6.9) | 1 [Reference] | 1332/21089 (6.3) | 1 [Reference] | 1715/30584 (5.6) | 1 [Reference] |
| High | 375/5577 (6.7) | 0.93 (0.77-1.12) | 169/3353 (5.0) | 0.82 (0.67-0.99) | 1281/27753 (4.6) | 0.83 (0.74-0.93) |
| 30-d Mortality and stroke | ||||||
| SAVR volume | ||||||
| Low | 626/6526 (9.6) | 1 [Reference] | 1195/13924 (8.6) | 1 [Reference] | 2203/28263 (7.8) | 1 [Reference] |
| High | 413/4436 (9.3) | 0.96 (0.81-1.13) | 905/10518 (8.6) | 0.97 (0.86-1.10) | 2206/30074 (7.3) | 0.98 (0.89-1.07) |
| TAVR volume | ||||||
| Low | 513/5385 (9.5) | 1 [Reference] | 1864/21089 (8.8) | 1 [Reference] | 2470/30584 (8.1) | 1 [Reference] |
| High | 526/5577 (9.4) | 0.96 (0.83-1.12) | 236/3353 (7.0) | 0.83 (0.71-0.97) | 1939/27753 (7.0) | 0.84 (0.77-0.93) |
| 30-d Readmission | ||||||
| SAVR volume | ||||||
| Low | 1690/6526 (25.9) | 1 [Reference] | 3470/13924 (24.9) | 1 [Reference] | 6522/28263 (23.1) | 1 [Reference] |
| High | 1191/4436 (26.9) | 1.00 (0.88-1.14) | 2668/10518 (25.4) | 1.01 (0.92-1.12) | 6565/30074 (21.8) | 0.98 (0.91-1.06) |
| TAVR volume | ||||||
| Low | 1376/5383 (25.6) | 1 [Reference] | 5293/21089 (25.1) | 1 [Reference] | 7175/30584 (23.5) | 1 [Reference] |
| High | 1505/5577 (26.9) | 1.04 (0.93-1.17) | 845/3353 (25.2) | 0.99 (0.88-1.13) | 5912/27753 (21.3) | 0.91 (0.84-0.98) |
| Estimated Risk, % | Adjusted HR (95% CI) | Estimated Risk, % | Adjusted HR (95% CI) | Estimated Risk, % | Adjusted HR (95% CI) | |
| Patients, No. | 11 098 | 24 751 | 60 538 | |||
| 1-y Mortality | ||||||
| SAVR volume | ||||||
| Low | 23.1 | 1 [Reference] | 21.9 | 1 [Reference] | 20.3 | 1 [Reference] |
| High | 24.3 | 0.98 (0.85-1.12) | 22.0 | 0.96 (0.88-1.05) | 19.3 | 0.97 (0.91-1.04) |
| TAVR volume | ||||||
| Low | 23.6 | 1 [Reference] | 22.4 | 1 [Reference] | 20.8 | 1 [Reference] |
| High | 23.7 | 0.93 (0.84-1.03) | 19.1 | 0.85 (0.78-0.92) | 18.8 | 0.87 (0.81-0.94) |
| 2-y Mortality | ||||||
| SAVR volume | ||||||
| Low | 34.7 | 1 [Reference] | 33.9 | 1 [Reference] | 32.2 | 1 [Reference] |
| High | 35.8 | 0.97 (0.87-1.08) | 33.3 | 0.94 (0.87-1.01) | 30.9 | 0.97 (0.92-1.03) |
| TAVR volume | ||||||
| Low | 35.1 | 1 [Reference] | 34.0 | 1 [Reference] | 32.5 | 1 [Reference] |
| High | 35.3 | 0.94 (0.87-1.03) | 31.1 | 0.88 (0.83-0.93) | 30.5 | 0.89 (0.84-0.95) |
Abbreviations: HR, hazard ratio; OR, odds ratio; SAVR, surgical aortic valve replacement; TAVR, transcatheter aortic valve replacement.