E-50 | Impact of acute kidney injury on hospitalized obese patients undergoing Transcatheter Aortic Valve Replacement (TAVR): Insight from the National Inpatient Sample 2020

Increasing evidence shows the prognostic value of post-transcatheter aortic valve replacement acute kidney injury (post-TAVR AKI) in terms of increased short- and long-term all-cause mortality. However, the definitive impact of AKI among obese patients (BMI≥30) hospitalized for TAVR remains unclear. This study aims to examine the influence of AKI on in-hospital outcomes among obese patients undergoing TAVR. We examined the 2020 U.S. National Inpatient Sample (NIS) to investigate the impact of AKI on obese patients undergoing TAVR. Participants aged≥18 years old with BMI≥30 were included in the analysis using relevant ICD-10 CM and PCS codes. Statistical analysis was conducted using multivariable logistic and linear regression analyses, and adjusted odds ratios (aORs) were calculated for the specified outcomes. Statistical significance was considered when the P value was < 0.05. We identified 16,530 obese patients undergoing TAVR, with a mean age of 74±8 years; 48.6% were female. Caucasians accounted for 88%, followed by Blacks (5%), Mexican Americans (5%), and Asians (0.4%). Of these, 9.5% (1,570/16,530) had a concurrent diagnosis of AKI. Data from a survey multivariable regression analysis, adjusting for patients and hospital factors, showed that obese patients with AKI after TAVR had statistically higher in-hospital mortality (aOR 15.95, p <0.001), prolonged length of hospital stay (βLOS 7.38, p <0.001), increased risk of sepsis (aOR 18.96, p 0.013), venous thromboembolism (aOR 9.21, p 0.008), intra-operative stroke (aOR 18.96, p 0.029), mechanical ventilation use (aOR 9.71, p <0.001), respiratory failure (aOR 8.82, p <0.001), cardiogenic shock (aOR 11.77, p <0.001), and pacemaker implantation (aOR 2.38, p <0.001), compared to those without AKI. Our data shows the adverse effect between AKI and adverse in-hospital outcomes, such as in-hospital mortality, extended hospital stays, and complicated hospital courses. Future longitudinal cohort studies are suggested to gain more insight into this association.