Affiliation:
1. Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
2. Department of Cardiology, Handan First Hospital, Handan, Hebei, China.
Abstract
Patients undergoing transcatheter aortic valve replacement (TAVR) have a high comorbid burden. Our objective was to assess the association between the age-adjusted Charlson comorbidity index (Age-CCI) and mortality and readmission rates within 1-year post-TAVR. Data were extracted from the Medical Information Mart for Intensive Care IV database (MIMIC-IV version 2.0). The primary endpoint was a composite outcome of all-cause mortality or readmission within 1-year after TAVR. To examine the associations of Age-CCI with outcomes, we used multivariable Cox proportional hazards regression, restricted cubic spline (RCS), and Kaplan–Meier curves. A total of 785 patients (52.9% male) with a median age of 84.0 years were assessed. More than half of our patients had an Age-CCI ≥ 7. After adjustment for potential confounders, we found that a 1 unit increase in Age-CCI was associated with a 10% increase in mortality and readmission rates after TAVR (HR = 1.10, 95% CI: 1.04–1.17, P < .001). High Age-CCI (Age-CCI ≥ 7) compared with the low Age-CCI (Age-CCI < 7) showed a 36% increase of mortality and readmission rates (HR = 1.36, 95% CI: 1.07–1.73, P = .013). The RCS curve analysis showed a continuous linear relationship between Age-CCI and the composite outcome risk (P for non-linearity = .671). The Kaplan–Meier survival analysis showed that patients with Age-CCI ≥ 7 had a poorer prognosis than those with Age-CCI < 7 (log-rank P < .001). Subgroup analyses showed the results remained stable. Age-CCI is independently associated with all-cause mortality and readmission in patients treated with TAVR, which may help clinicians risk-stratify patients and offer an opportunity to improve patient outcomes.
Publisher
Ovid Technologies (Wolters Kluwer Health)