Compared with patients younger than 70, those older than 90 undergoing TAVI had a significantly increased risk of mortality (OR 1.68; 95% CI 1.33-2.12; P<0.001) and readmission.
Cohort (n=84,017)
Yes
Does advanced age increase the risk of procedural complications, mortality, and readmission in patients undergoing TAVI?
In patients undergoing TAVI, advanced age (≥80 years) is associated with a significantly increased risk of mortality, readmissions, and procedural complications compared to patients younger than 70.
Odds Ratio: 1.68 (95% CI 1.33–2.12)
p-value: p=<0.001
AIMS: Usage of transcatheter aortic valve implantation (TAVI) for treatment of severe aortic stenosis is increasing across age groups. However, literature on age-specific TAVI outcomes is lacking. The purpose of this study is to assess the risks of procedural complications, mortality, and readmission in patients undergoing TAVI across different age groups. METHODS AND RESULTS: The Nationwide Readmissions Database was used to identify 84 017 patients undergoing TAVI from 2016 to 2018. Patients were stratified into four age groups: younger than 70, 70-79, 80-89, and older than 90. Complications, mortality, and readmission rates were compared between groups in a proportional hazards regression model. Risk of post-procedural stroke, acute kidney injury, and pacemaker or implantable cardioverter defibrillator implantation increased with incremental age grouping. Compared with patients younger than 70, patients aged 70-79 had no significant difference in mortality, whereas patients aged 80-89 and older than 90 had an increased mortality risk odds ratio (OR) 1.39, confidence interval (CI) 1.14-1.70, P = 0.001 and OR 1.68, CI 1.33-2.12, P < 0.001, respectively. Patients aged 80-89 and older than 90 had increased overall readmission compared with patients younger than 70 (HR 1.09, CI 1.03-1.14, P = 0.001 and HR 1.33, CI 1.25-1.41, P < 0.001, respectively). Cardiac readmissions followed the same trend. CONCLUSION: Patients aged 80-89 and older than 90 undergoing TAVI have increased risk of readmission, complications, and mortality compared with patients younger than 70.
Delijani et al. (2022) conducted a cohort in Severe aortic stenosis (n=84,017). Age >90 years vs. Age <70 years was evaluated on Mortality (OR 1.68, 95% CI 1.33-2.12, p=<0.001). Compared with patients younger than 70, those older than 90 undergoing TAVI had a significantly increased risk of mortality (OR 1.68; 95% CI 1.33-2.12; P<0.001) and readmission.