Study Shows Association Between Hospital Volume and Outcomes for TAVR in the United States

December 11, 2015—Findings from a study conducted to analyze in-hospital outcomes after transcatheter aortic valve replacement (TAVR), stratified according to hospital volumes, were published by Luke K. Kim, MD, et al in the American Journal of Cardiology (2015;116:1910–1915). 

The investigators concluded that centers with lower volumes of TAVR had more frequent adverse events compared with higher-volume centers.

Using the National Inpatient Sample files from 2012, hospitals performing transfemoral (TF)-TAVR and transapical (TA)-TAVR were divided into high-volume and low-volume centers. A total of 7,660 patients underwent TAVR in 256 hospitals in 2012. 

The investigators found that in the TF-TAVR cohort, multivariate logistic regression analyses demonstrated that low TF-TAVR volume status was an independent predictor of death and bleeding. In the TA-TAVR cohort, low volume status was a predictor of death, myocardial infarction, and a need for a permanent pacemaker. In addition, hospitals that performed low TA-TAVR volume were associated with a significantly higher rate of death after surgical aortic valve replacement in comparison with the hospitals that perform high TA-TAVR volume (3.6% vs 2.3%; P < .001), reported the investigators in the American Journal of Cardiology.