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Abstract
Nationally representative estimates of in-hospital mortality after aortic valve replacement
are needed to evaluate whether results from The Society of Thoracic Surgeons National
Cardiac Surgery Database are applicable to other institutions in the United States
performing these procedures.
Data from the 1994 Nationwide Inpatient Sample were used to estimate the patient characteristics
and in-hospital mortality rates associated with aortic valve replacements performed
in nonfederal hospitals in the United States. Procedural and hospital characteristics
were examined for possible associations with in-hospital mortality.
An estimated 46,397 aortic valve replacements were performed. In-hospital mortality
occurred in 4.3% of first-time isolated aortic valve replacements and 6.4% overall.
The highest quartile of procedure-specific hospital volume, compared with the lowest
quartile, was associated with lower in-hospital mortality (adjusted odds ratio, 0.58;
95% confidence interval, 0.42 to 0.81).
The in-hospital mortality rates observed in this study are very similar to those reported
from The Society of Thoracic Surgeons database. These data provide substantial evidence
that results from The Society of Thoracic Surgeons database are representative of
those achieved at other institutions. However, procedure-specific hospital volume
must be considered in applying these results to individual institutions.