Perioperative TAVR Leads to Higher Rates of Inpatient Mortality in Hip Fracture Patients

Abstract

Abstract Background Transcatheter aortic valve replacement (TAVR) has emerged as a minimally invasive method to treat severe aortic stenosis and has been utilized in select hip fracture patients as part of their medical optimization for surgery. We compared complication rates in hip fracture patients with aortic stenosis who had perioperative TAVR (TAS) to those who did not (AS). Methods A retrospective review of 81 consecutive hip fracture patients with aortic stenosis (TAS: 10, AS: 71) admitted between 2014–2018 at a level 1 trauma center was performed. The outcomes of the study were inpatient mortality, postoperative complications, and length of stay (LOS). Results The average age of the TAS cohort was 89 years old, compared to 90 for the AS cohort (P = 0.382). Overall inpatient complications trended higher in the TAS group with 90%, compared to 62% in the AS group (P = 0.152). Amongst complications, transfusion rate was significantly higher for the TAS cohort (70% versus 30%; P = 0.027), as well as inpatient mortality rate (30% versus 4.2%; P = 0.022). Average LOS for the TAS group was 10 days versus 6 days in the AS group (P = 0.013). Conclusion The TAS cohort had a higher transfusion rates, longer LOS, and a higher inpatient mortality rate. Overall complication rates trended higher for the TAVR cohort. Trial Registration: Retrospectively registered.