Key result
The overall in-hospital mortality rate for valvular heart disease surgery in China was 2.17%, with significant regional variations in risk-standardized mortality rates ranging from 0.91% to 3.99%.
Why the study?
To characterize surgical valvular heart diseases and evaluate regional variations in valvular heart disease surgeries in China using national registry data.
Observational (n=38,131)
Yes
While the overall in-hospital mortality rate for valvular heart disease surgery in large Chinese centers is comparable to developed countries (2.17%), there are substantial regional disparities in patient risk profiles and surgical outcomes across China.
Answers are grounded in this paper and cite their sources.
Regional disparities in valvular surgery mortality persist across China; leaves open drivers and equity-focused interventions for prospective study.
AimsTo characterize surgical valvular heart diseases (VHDs) in China and disclose regional variations in VHD surgeries by analyzing the data derived from the Chinese Cardiac Surgery Registry (CCSR).Methods and resultsFrom January 2016 to December 2018, we consecutively collected the demographic information, clinical characteristics and outcomes of 38131 patients undergoing valvular surgery in China. We sought to assess the quality of VHD surgery by examining in-hospital deaths of all patients from 7 geographic regions. Using a hierarchical generalized linear model, we calculated the risk-standardized mortality rate (RSMR) of each region. By comparing VHD characteristics and RSMRs, we pursued an investigation into regional variations. The mean age was 54.4±12.4 years, and 47.2% of the patients were females. Among cases, the number of aortic valve surgeries was 9361 (24.5%), which was less than that of mitral valve surgeries (n=14506, 38.0%). The number of both aortic and mitral valve surgeries was 6984 (18.3%). A total of 4529 surgical VHD patients (11.9%) also underwent coronary artery bypass grafting (CABG) surgery. The overall in-hospital mortality rate was 2.17%. The lowest RSMR, 0.91%, was found in the southwest region, and the highest RSMR, 3.99%, was found in the northeast.ConclusionAlthough the overall valvular surgical mortality rate in large Chinese cardiac centers was in line with developed countries, there were marked regional variations in the characteristics and outcomes of surgical VHD patients across China.
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Lin et al. (2022) conducted an observational in Acquired Valvular Heart Disease (n=38,131). Valvular heart disease surgery vs. Across 7 geographic regions was evaluated on In-hospital mortality. The overall in-hospital mortality rate for valvular heart disease surgery in China was 2.17%, with significant regional variations in risk-standardized mortality rates ranging from 0.91% to 3.99%.
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