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Open Access 01-12-2015 | Research article

In-hospital resource utilization in surgical and transcatheter aortic valve replacement

Authors: Jochen Reinöhl, Klaus Kaier, Anja Gutmann, Stefan Sorg, Constantin von zur Mühlen, Matthias Siepe, Hardy Baumbach, Martin Moser, Annette Geibel, Andreas Zirlik, Philipp Blanke, Werner Vach, Friedhelm Beyersdorf, Christoph Bode, Manfred Zehender

Published in: BMC Cardiovascular Disorders | Issue 1/2015

Abstract

Background

Little is known about preoperative predictors of resource utilization in the treatment of high-risk patients with severe symptomatic aortic valve stenosis. We report results from the prospective, medical-economic “TAVI Calculation of Costs Trial”.

Methods

In-hospital resource utilization was evaluated in 110 elderly patients (age ≥ 75 years) treated either with transfemoral (TF) or transapical (TA) transcatheter aortic valve implantation (TAVI, N = 83), or surgical aortic valve replacement (AVR, N = 27). Overall, 22 patient-specific baseline parameters were tested for within-group prediction of resource use.

Results

Baseline characteristics differed between groups and reflected the non-randomized, real-world allocation of treatment options. Overall procedural times were shortest for TAVI, intensive care unit (ICU) length of stay (LoS) was lowest for AVR. Length of total hospitalization since procedure (THsP) was lowest for TF-TAVI; 13.4 ± 11.4 days as compared to 15.7 ± 10.5 and 21.2 ± 15.4 days for AVR and TA-TAVI, respectively. For TAVI and AVR, EuroScore I remained the main predictor for prolonged THsP (p <0.01). Within the TAVI group, multivariate regression analyses showed that TA-TAVI was associated with a substantial increase in THsP (55 to 61 %, p <0.01). Additionally, preoperative aortic valve area (AVA) was identified as an independent predictor of prolonged THsP in TAVI patients, irrespective of risk scores (p <0.05).

Conclusions

Our results demonstrate significant heterogeneity in patients baseline characteristics dependent on treatment and corresponding differences in resource utilization. Prolonged ThsP is not only predicted by risk scores but also by baseline AVA, which might be useful in stratifying TAVI patients.

Trial registration

German Clinical Trial Register Nr. DRKS00000797

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Title: In-hospital resource utilization in surgical and transcatheter aortic valve replacement
Authors: Jochen Reinöhl
Klaus Kaier
Anja Gutmann
Stefan Sorg
Constantin von zur Mühlen
Matthias Siepe
Hardy Baumbach
Martin Moser
Annette Geibel
Andreas Zirlik
Philipp Blanke
Werner Vach
Friedhelm Beyersdorf
Christoph Bode
Manfred Zehender
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: BMC Cardiovascular Disorders / Issue 1/2015
Electronic ISSN: 1471-2261
DOI: https://doi.org/10.1186/s12872-015-0118-x

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In-hospital resource utilization in surgical and transcatheter aortic valve replacement

Abstract

Background

Methods

Results

Conclusions

Trial registration

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