Back to Search
Start Over
Utilization, In-Hospital Mortality, and 30-Day Readmission After Percutaneous Mitral Valve Repair in the United States Shortly After Device Approval
- Source :
- The American Journal of Cardiology. 121:1365-1372
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- The MitraClip device for percutaneous mitral valve repair was approved by the Food and Drug Administration in the United States in October 2013. Few studies have evaluated national outcomes after this procedure in routine clinical practice. We identified adults aged ≥18 years who received percutaneous mitral valve repair from November 2013 to December 2014 in the Nationwide Readmissions Database, a publicly available administrative claims database. Procedural volumes, number of performing hospitals, individual hospital volumes, in-hospital mortality rate, and 30-day hospital readmission rate were determined. Patient demographics, clinical comorbidities, and hospital characteristics were analyzed using logistic regression to determine risk factors for in-hospital death and 30-day readmission. We identified 879 cases performed in the first 14 months after device approval (mean age ± SD, 75.0 ± 13.1 years; 45% women). The number of performing hospitals increased by 5.7-fold (23 to 132), although mean individual hospital volumes remained small (6.2 ± 10.4 cases per hospital). In-hospital all-cause mortality was 3.3% and was associated with higher number of clinical comorbidities. The rate of 30-day readmission was 14.6%, and 6.6% of patients died during rehospitalization. Increased procedural experience was associated with a nonsignificant trend toward reduced hospital readmission after multivariable adjustment (p = 0.08). In conclusion, use of percutaneous mitral valve repair in the United States early after approval increased steadily over time, although individual hospital volumes remained low. More than 1 in 7 patients who underwent this procedure are readmitted within 30 days of discharge.
- Subjects :
- Male
Cardiac Catheterization
medicine.medical_specialty
Mitral Valve Annuloplasty
Device Approval
MEDLINE
030204 cardiovascular system & hematology
Logistic regression
Patient Readmission
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Hospital Mortality
030212 general & internal medicine
Aged
Aged, 80 and over
Hospital readmission
In hospital mortality
business.industry
MitraClip
Mortality rate
Mitral Valve Insufficiency
Health Services
Middle Aged
United States
Logistic Models
Emergency medicine
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Percutaneous Mitral Valve Repair
Subjects
Details
- ISSN :
- 00029149
- Volume :
- 121
- Database :
- OpenAIRE
- Journal :
- The American Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....9b822560c95eb4a9500e1299ffc3e4c1