My library button

No image available

Hospital Intervention Volume Affects Outcomes of Emergency Transcatheter Aortic Valve Implantations in Germany

by Vera Oettinger, Adrian Heidenreich, Klaus Kaier, Manfred Karl-Heinz Zehender, Christoph Bode, Daniel Frank Dürschmied, Constantin von Zur Mühlen, Dirk Westermann, Peter Stachon · 2022

Book is in your Library

ISBN:  Unavailable

Category: Unavailable

Page count: Unavailable

Abstract: The literature has shown an inverse volume-outcome relationship for transcatheter aortic valve implantation (TAVI). However, little is known about emergency admissions in Germany. Using German national electronic health records, we identified all isolated balloon-expandable and self-expanding transfemoral TAVI in 2018. The focus was on those patients with emergency admission. 17,295 patients were treated with TAVI, including 1682 emergency cases. 49.2% of the emergency admissions were female, the mean age was 81.2 years and the logistic EuroSCORE was 23.3%. The percentage of emergency cases was higher in lower volume than in higher volume centers (p 0.001): In detail, centers performing 50 TAVI showed an emergency admission rate of ~ 15%, those with 200 TAVI a rate of ~ 11%. After propensity score adjustment, analyzing the outcomes for an increase in volume per 10 emergency admissions, higher volume centers showed significantly better outcomes regarding in-hospital mortality (OR = 0.872, p = 0.043), major bleeding (OR = 0.772, p = 0.001), stroke (OR = 0.816, p = 0.044), mechanical ventilation 48 h (OR = 0.749, p = 0.001), length of hospital stay (risk adjusted difference in days of hospitalization per 10 emergency admissions: − 1.01 days, p