Metropolitan Hospital Center, Department of Medicine, New York Medical College, New York City, New York.
Department of Internal Medicine, Carle Foundation, Urbana, Illinois.
Am J Cardiol. 2023 Jul 1;198:33-35. doi: 10.1016/j.amjcard.2023.04.019. Epub 2023 May 15.
Transcatheter aortic valve implantation (TAVI) has been increasingly performed among extreme elderly patients with symptomatic severe aortic stenosis. We aimed to study the trends, characteristics, and outcomes of TAVI among extreme elderly. The National Readmission Database for the years 2016 to 2019 was queried for extreme elderly who underwent TAVI. Linear regression analysis was used to calculate the temporal trends in outcomes. A total of 23,507 TAVI extreme elderly admissions (50.3% women and 95.9% Medicare insurance) were included. The in-hospital mortality and all-cause 30-day readmissions were 2% and 15% and have been stable over years of analysis (p trend = 0.79 and 0.06, respectively). We evaluated complications, such as permanent pacemaker implantation (12%) and stroke (3.2%). Stroke rates did not decrease (3.4% vs 2.9% in 2016 and 2019 [p trend = 0.24]). The mean length of stay improved from 5.5 days in 2016 to 4.3 days in 2019 (p trend <0.01). The rates of early discharge (day ≤3) has improved from 49% in 2016 to 69% in 2019 (p trend <0.01). In conclusion, this nationwide contemporary observational analysis showed that TAVI was associated with low rates of complications in the extreme elderly.
经导管主动脉瓣植入术（TAVI）在有症状的严重主动脉瓣狭窄的超高龄患者中越来越多地进行。我们旨在研究超高龄患者 TAVI 的趋势、特征和结果。2016 年至 2019 年，国家再入院数据库对接受 TAVI 的超高龄患者进行了查询。线性回归分析用于计算结果的时间趋势。共纳入 23507 例 TAVI 超高龄患者（50.3%为女性，95.9%为医疗保险）。住院死亡率和全因 30 天再入院率分别为 2%和 15%，且多年分析结果保持稳定（p 趋势=0.79 和 0.06）。我们评估了并发症，如永久性起搏器植入（12%）和中风（3.2%）。中风发生率并未降低（2016 年为 3.4%，2019 年为 2.9%[p 趋势=0.24]）。平均住院时间从 2016 年的 5.5 天缩短至 2019 年的 4.3 天（p 趋势<0.01）。早期出院（出院日≤3 天）的比例从 2016 年的 49%提高到 2019 年的 69%（p 趋势<0.01）。总之，这项全国性的当代观察性分析表明，TAVI 在超高龄患者中与较低的并发症发生率相关。
