Key result
High surgical risk links to double the 5-year mortality after aortic valve replacement.
Why the study?
Long-term medical resource use and costs after surgical AVR in high-risk versus non-high-risk patients with aortic stenosis were not well characterized.
Do long-term clinical and economic outcomes differ between high-risk and non-high-risk Medicare patients undergoing surgical aortic valve replacement?
Population
1,474 Medicare patients with aortic stenosis undergoing surgical AVR
Comparison
High-risk (logistic EuroSCORE > 20%) vs non-high-risk patients
Design
Retrospective cohort study using Medicare 5% Standard Analytic Files
Follow-up
5 years
Authors
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High surgical risk identifies Medicare AVR patients with poor long-term survival; leaves open whether TAVR improves outcomes in this population.
Cohort (n=1,474)
Do long-term clinical and economic outcomes differ between high-risk and non-high-risk Medicare patients undergoing surgical aortic valve replacement?
Absolute Event Rate: 66.7% vs 33.2%
High-risk elderly patients undergoing surgical aortic valve replacement experience substantially higher 5-year mortality and healthcare costs compared to non-high-risk patients, underscoring the potential value of less invasive alternatives like TAVR.
Clark et al. (2012) conducted a cohort in Aortic stenosis (n=1,474). High surgical risk (logistic EuroSCORE > 20%) vs. Non-high surgical risk was evaluated on All-cause mortality at 5 years. High surgical risk in Medicare patients undergoing aortic valve replacement was associated with higher 5-year all-cause mortality compared to non-high-risk patients (66.7% vs 33.2%).
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