Transcatheter aortic valve implantation (TAVI) has skyrocketed in the United States, jumping from 24.8 implants per million adults in 2012 to 63.2 in 2014. A recent study examined regional differences in mortality, utilization and healthcare resource use.
The research—led by Tanush Gupta, MD, with the Albert Einstein College of Medicine in New York, and Ankur Kalra, MD, with Case Western Reserve University School of Medicine in Cleveland—was published August 10 in the American Journal of Cardiology.
“We observed significant regional differences in TAVI utilization, in-hospital mortality, and healthcare resource use in the U.S.,” wrote Gupta and colleagues. “The findings of our study may have important policy implications and should provide an impetus to understand the source of this regional variation.”
The team collected data on 41,025 TAVI procedures in the U.S. between 2012 and 2014 from the National Inpatient Sample Database—14,095 were performed in the South, 10,390 in the Northeast, 9,090 in the Midwest and 7,450 in the West.
“The number of TAVI procedures per million population aged ≥18 years was highest in the Northeast followed by the Midwest, South, and the West, respectively,” Gupta et al. wrote. “These findings could partly be related to variation in the number of eligible TAVI recipients among the 4 regions. The number of potential TAVI candidates is likely to be related to the proportion of the elderly population in the respective regions.”
Overall mortality was 4.2 percent, with the South having the highest at 5 percent and the West the lowest at 3.5 percent.
“A ‘learning-curve’ effect has also been described for TAVI with increasing procedural proficiency with greater hospital experience,” the researchers wrote. “Regional differences in the timing of institution of new TAVI hospitals during the study period could have also contributed to the observed regional variation in risk-adjusted in-hospital mortality.”
Average length of stay was consistently around five or six days across all regions, while costs were highest in the West ($56.626) and lowest in the South ($50,639).
Nicholas joined TriMed in 2016 as the managing editor of the Chicago office. After receiving his master’s from Roosevelt University, he worked in various writing/editing roles for magazines ranging in topic from billiards to metallurgy. Currently on Chicago’s north side, Nicholas keeps busy by running, reading and talking to his two cats.