C-78 | In-Hospital Mortality After SAVR Versus TAVR: A Nationwide Study with Machine Learning–Based Risk Prediction

Background: Transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) are two preferred methods for treating aortic stenosis.This study compared the in-hospital mortality rates associated with SAVR and TAVR.Methods: In accordance with the STROBE guidelines, we conducted an study utilizing data from National Readmission Database (NRD) from 2016 to 2020.Patients undergoing TAVR or SAVR were identified using specific ICD-10 procedure codes.Adjusted multivariate logistic regression analysis to determine the odds ratio (OR) of death associated with SAVR compared to TAVR.AI based XGBoost model were used to find the predictors of mortality.Results: Our study included a total of 361,875 patients.Among these, 182,443 underwent TAVR, while 179,432 underwent SAVR.In the TAVR group, 2,563 patients (1.4%) died during hospitalization, whereas 6,671 patients (3.7%) died in the SAVR group.The multivariate logistic regression analysis indicated that SAVR is associated with higher inhospital mortality (OR = 2.66, 95% CI 2.51-2.81,p < 0.001) compared to TAVR.Follow up data at 30 days, three months, six months, and a year did not find any difference in mortality between TAVR and SAVR.Notably, liver failure, HLD, renal failure, female, CHF, and atrial fibrillation are amongst the top predictor of mortality in SAVR patients.Conclusions: Our study demonstrates that SAVR is associated with a higher likelihood of in-hospital mortality compared to TAVR.Predictors of worse outcomes with SAVR liver failure, HLD, renal failure, female, CHF, and atrial fibrillation.