Hospitals With Higher SAVR Mortality Also Have Higher TAVR Mortality

Hospitals with low-risk surgical aortic valve replacement (SAVR) programs also achieved better outcomes for transcatheter aortic valve replacement (TAVR) programs.

A new cohort study published in JAMA Cardiology included patients (65 and older) and used CMS Medicare Provider and Review data collected between 2010 and 2015. The researchers measured hospital risk-adjusted 30-day mortality after surgery as a surrogate for SAVR quality, and then examined 30-day and 1-year risk-adjusted TAVR rates and stratified them into quartiles based on hospital risk-adjusted SAVR mortality. A total of 51,924 TAVR procedures were performed.

Hospitals with higher #SAVR mortality rates also had higher short- and long-term #TAVR mortality after initiating TAVR programs. https://t.co/QgKSq1Egju pic.twitter.com/2GkLWQigJv

— JAMA Cardiology (@JAMACardio) January 21, 2019

According to the results, observed 30-day mortality rates tracked with increasing baseline hospital risk-adjusted mortality (P<0.001 for all quartiles), as did 1-year mortality (P<0.001 for all quartiles). Following multivariable analysis, TAVR 30-day mortality (P=0.02) and 1-year (P=0.02) mortality at hospitals with higher baseline SAVR mortality were also higher.

“Hospitals with higher SAVR mortality rates also had higher short-term and long-term TAVR mortality after initiating TAVR programs,” the researchers wrote in their conclusion. “Quality of cardiac surgical care may be associated with a hospital’s performance with new structural heart disease programs.”

Study shows the importance of cardiac surgical quality and hospital performance: facilities with higher SAVR mortality rates also experienced higher short- and long-term mortality rates when initiating TAVR programs. #biom4180 https://t.co/3fqiey6X5n

— Jade Marrow, PhD (@jade_marrow96) January 21, 2019

https://twitter.com/cpgale3/statuses/1086911018264088576

Important #TAVR article via @JAMACardio here: https://t.co/PhB9Mk7jmB

— CVRNB (@HeartResearchNB) January 20, 2019

#TAVR outcomes better w a strong #HeartTeam and high quality #SAVR program! #UABStructualHeart Hospital Surgical Aortic Valve Replacement Quality and Mortality After Transcatheter Aortic Valve Replacement https://t.co/jpB6rLPwgY

— Lisa Findley (@lisafindley) January 18, 2019

Association of Hospital Surgical Aortic Valve Replacement Quality With 30-Day and 1-Year Mortality After #TAVR. Great ⁦work by @rwyeh⁩ et al ⁦@JAMACardio⁩ showing hospitals with high quality #SAVR assoc with best TAVR outcomes https://t.co/vqTdszgPqm

— Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 (@DrMarthaGulati) January 17, 2019

Source: JAMA Cardiology