Valvular Heart DiseaseImpact of Cirrhosis in Patients Who Underwent Surgical Aortic Valve Replacement
Section snippets
Methods
Using methods previously described by our group,14, 15 the Nationwide Inpatient Sample (NIS) Healthcare Cost Utilization Project database was queried from 1998 to 2011 for patients who underwent AVR using the 2003 International Statistical Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis and procedure codes. The database contains individual entries on information regarding demographics, hospital characteristics, co-morbidity, hospital charges, length of
Results
Tables 1 and 2 demonstrate the demographics and co-morbidities between patients with cirrhosis and those without, respectively. The number of aortic valve replacements per year done on patients with cirrhosis more than tripled during our study, from 123 to 388 (Figure 1). That correlated to a jump from 6 per 1,000 cases to 9 per 1,000 cases. The overall mortality rate for patients with cirrhosis was 16%. The yearly mortality rate varied from 10% per year to 34% per year (Figure 1). The
Discussion
The presence of cirrhosis dramatically changes the outcome after isolated surgical aortic valve replacement. Cirrhosis increased the mortality risk by a factor of 3.6, with an overall mortality rate of 16%. More than half of the patients with cirrhosis experienced a complication, with an adjusted odds ratio of 1.5. More than 25% of patients with cirrhosis had postoperative acute renal failure, more than twice the rate of the noncirrhotic matched pairs. In addition, they were more likely to be
Disclosures
The authors have no conflicts of interest to disclose.
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