Bhardwaj Bhaskar, Karuparthi Poorna R, Desai Rupak, Fong Hee Kong, Aggarwal Kul
Department of Internal Medicine, Division of Cardiovascular Medicine, University of Missouri-Columbia, Columbia, USA.
Department of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, USA.
Cureus. 2020 Aug 27;12(8):e10074. doi: 10.7759/cureus.10074.
Background The prevalence and impact of anemia on the outcomes of transcatheter mitral valve repair (TMVr) have not been well-studied. Anemia is a commonly encountered comorbidity among patients with cardiovascular disorders and is frequently under-recognized. The study aimed to analyze the prevalence of anemia and its impact on post-TMVr in-hospital outcomes. Methods The National Inpatient Sample (NIS) was queried to identify all patients who underwent TMVr from 2011-2015 in the United States by utilizing suitable International Classification of Diseases, Ninth Revision (ICD-9) codes. The baseline characteristics and in-hospital outcomes were compared among patients with and without anemia. Results A total of 4,382 patients were identified. Out of these, 978 (22.3%) patients had baseline anemia. Anemic patients were noted to have a higher burden of co-morbidities, including chronic kidney disease, hypertension, and diabetes mellitus. The in-hospital mortality was higher but not statistically significant between anemic and non-anemic patients (3.6% vs 2.6%; odds ratio (OR): 1.44; confidence interval (CI): 0.85-2.46, p=0.179). The other adverse outcomes, including the length of stay, the requirement for blood transfusions, the incidence of post-implant acute kidney injury, hemodialysis, and the cost of hospitalization, were higher in anemic patients. Conclusion Anemia was present in one out of five patients undergoing TMVr in this nationally representative cohort. Baseline anemia showed numerically higher but not statistically significant in-hospital mortality and was associated with other in-hospital adverse outcomes. Further larger studies are needed to highlight the importance of anemia in the TMVr procedure.
贫血对经导管二尖瓣修复术（TMVr）结局的患病率及影响尚未得到充分研究。贫血是心血管疾病患者中常见的合并症，且常常未得到充分认识。本研究旨在分析贫血的患病率及其对TMVr术后院内结局的影响。方法：通过使用合适的国际疾病分类第九版（ICD-9）编码，查询国家住院样本（NIS）以识别2011年至2015年在美国接受TMVr的所有患者。比较有无贫血患者的基线特征和院内结局。结果：共识别出4382例患者。其中，978例（22.3%）患者基线存在贫血。贫血患者的合并症负担更高，包括慢性肾脏病、高血压和糖尿病。贫血患者与非贫血患者的院内死亡率较高，但无统计学意义（3.6%对2.6%；比值比（OR）：1.44；置信区间（CI）：0.85 - 2.46，p = 0.179）。贫血患者的其他不良结局，包括住院时间、输血需求、植入后急性肾损伤发生率、血液透析及住院费用均更高。结论：在这个具有全国代表性的队列中，每五名接受TMVr的患者中就有一名存在贫血。基线贫血在数值上显示出较高的院内死亡率，但无统计学意义，且与其他院内不良结局相关。需要进一步开展更大规模的研究以突出贫血在TMVr手术中的重要性。
