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.

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.”

Source: JAMA Cardiology