E-52 | Impact of comorbid systemic lupus erythematosus (SLE) on the in-hospital outcome among patients hospitalized for Transcatheter Aortic Valve Replacement (TAVR): Insight from the National Inpatient Sample 2020

Recent studies indicate positive outcomes for transcatheter aortic valve replacement (TAVR) in connective tissue disease patients, with non-inferior mortality and a comparable risk of stroke. However, limited data exists on TAVR outcomes in the systemic lupus erythematosus (SLE) group. We aim to investigate in-hospital outcomes among SLE patients undergoing TAVR. We analyzed the 2020 U.S. National Inpatient Sample (NIS) to investigate the impact of comorbid SLE on in-hospital outcomes in patients undergoing TAVR. Participants≥18 years old were included using relevant ICD-10 CM and PCS codes. Multivariable logistic and linear regression analyses were employed to calculate adjusted odds ratios (aORs) for specific outcomes, with a significance level set at P < 0.05. We identified 75,740 patients undergoing TAVR, with a mean age of 77±8 years; 41.9% were female. Caucasians comprised 88%, followed by Blacks (4%), Mexican Americans (5%), and Asians (1%). Of these, 0.3% (250/75,740) had a concurrent diagnosis of SLE. In a survey multivariable regression model adjusting for patient and hospital factors, comorbid SLE showed an association with in-hospital mortality (aOR 5.12, p 0.011) and an increased risk of sepsis (aOR 16.23, p 0.002) compared with patients without SLE. Additionally, there was a tendency toward an increased risk of post-procedural bleeding in SLE patients, although the data did not reach statistical significance (aOR 2.03, p 0.061). No associations were identified between systemic lupus erythematosus (SLE) and in-hospital outcomes, including venous thromboembolism, mechanical ventilation use, respiratory failure, and cardiogenic shock. Our data demonstrates an association between comorbid SLE and in-hospital mortality, along with an increased risk of sepsis in patients admitted for TAVR. Monitoring this factor is crucial to mitigate post-procedural adverse outcomes.