Impact of social deprivation on outcome following transcatheter aortic valve implantation (TAVI).

TAVI length of stay mortality social deprivation

Journal

Open heart
ISSN: 2053-3624
Titre abrégé: Open Heart
Pays: England
ID NLM: 101631219

Informations de publication

Date de publication:
Historique:
received: 13 05 2019
revised: 07 10 2019
accepted: 18 11 2019
entrez: 8 1 2020
pubmed: 8 1 2020
medline: 8 1 2020
Statut: epublish

Résumé

We sought to evaluate whether socioeconomic status influences outcome after first-time transcatheter aortic valve implantation (TAVI). This is a single-centre study carried out in Swansea, South West Wales, UK between 5 November 2009 and 10 June 2018. Data included age, gender, domiciliary postal code, comorbidities, complications post-TAVI, length of stay, follow-up time and survival status. The Welsh Index of Multiple Deprivation, 2014 was used to stratify cases by level of social deprivation according to domiciliary postal codes. Study population was 387 patients of whom 213 (54.8%) were men with mean age ±SD of 82.8±8.3 years. Patients, who were less deprived (296 (76.4%)), were more likely to be older (83.5±7.9 vs 80.4±9.3, p<0.05) and to be married (83.2% vs 69.7%, p<0.05). Conversely, 'more deprived' patients (91 (23.6%)) were more likely to have a longer stay in hospital as compared with patients in the 'less deprived group' (29.6±32.7 days vs 21.3±21.1 days, p<0.05). However, 30-day, 1-year and 3-year survival/mortality rates were similar across all socioeconomic levels. This is the first study in which social deprivation has been investigated as a risk factor for mortality in a high-risk group of patients with severe aortic stenosis undergoing TAVI. Residing in a 'more deprived' area in South West Wales is not associated with adverse outcome following TAVI but patients who are 'more deprived' tend to stay longer in hospital compared with patients who are 'less deprived'.

Identifiants

pubmed: 31908812
doi: 10.1136/openhrt-2019-001089
pii: openhrt-2019-001089
pmc: PMC6927509
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e001089

Informations de copyright

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Références

Health Stat Q. 2006 Winter;(32):19-34
pubmed: 17165467
N Engl J Med. 2019 May 2;380(18):1695-1705
pubmed: 30883058
N Engl J Med. 1999 Oct 28;341(18):1359-67
pubmed: 10536129
J Intensive Care Soc. 2015 Feb;16(1):18-23
pubmed: 28979370
J Am Coll Cardiol. 2003 Jun 4;41(11):1948-54
pubmed: 12798563
Osteoporos Int. 2016 Sep;27(9):2727-2737
pubmed: 27098537
J Epidemiol Community Health. 2001 Jul;55(7):475-82
pubmed: 11413176
N Engl J Med. 2019 May 2;380(18):1706-1715
pubmed: 30883053
BMJ Open. 2015 Jun 29;5(6):e008287
pubmed: 26124512
BMJ. 2002 Jul 20;325(7356):134
pubmed: 12130608
Circulation. 2000 Aug 8;102(6):642-8
pubmed: 10931804
BMJ Open. 2012 Jun 18;2(3):null
pubmed: 22710128
Heart. 2003 Sep;89(9):1062-6
pubmed: 12923028
BMJ. 1997 Feb 22;314(7080):541-6
pubmed: 9055711
Eur Heart J. 2016 Dec 14;37(47):3515-3522
pubmed: 27354049
Eur J Prev Cardiol. 2016 Feb;23(3):316-27
pubmed: 25589410
J Thorac Cardiovasc Surg. 1990 Sep;100(3):327-37
pubmed: 2391969
Prog Cardiovasc Dis. 2014 May-Jun;56(6):565-71
pubmed: 24838132
Eur J Intern Med. 2018 Sep;55:12-19
pubmed: 30180946
BMJ. 2011 Feb 15;342:d508
pubmed: 21325004
J Am Coll Cardiol. 1987 Jul;10(1):66-72
pubmed: 3496372

Auteurs

Kevin Mohee (K)

Department of Cardiology, Morriston Hospital, Swansea Bay University Health Board, Swansea, UK.

Majd B Protty (MB)

Systems Immunity University Research Institute, Cardiff University, Cardiff, South Glamorgan, UK.

Tony Whiffen (T)

Welsh Government, Cardiff, Administrative Data Research Unit, Cardiff, UK.

Alexander Chase (A)

Department of Cardiology, Morriston Hospital, Swansea Bay University Health Board, Swansea, UK.

Dave Smith (D)

Department of Cardiology, Morriston Hospital, Swansea Bay University Health Board, Swansea, UK.

Classifications MeSH