{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T19:34:48Z","timestamp":1761766488706,"version":"3.41.2"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,1,22]]},"abstract":"\n Background<\/jats:title>\n \n Octogenarians have low physiologic reserve and may benefit more from transcatheter aortic valve replacement (\n TAVR<\/jats:styled-content>\n ) than surgical aortic valve replacement (\n SAVR<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n This retrospective cohort study based on the National Inpatient Sample included octogenarians who underwent\n TAVR<\/jats:styled-content>\n or\n SAVR<\/jats:styled-content>\n from 2012 to 2015. Crude and standardized\u2010morbidity\u2010ratio\u2010weighted regression models were used to compare in\u2010hospital outcomes. Among 19\u00a0145\n TAVR<\/jats:styled-content>\n and 9815\n SAVR<\/jats:styled-content>\n hospitalizations,\n TAVR<\/jats:styled-content>\n patients had higher Charlson Comorbidity Index (\n CCI<\/jats:styled-content>\n ) scores (2.0 versus 0.8,\n P<\/jats:italic>\n <0.0001) than\n SAVR<\/jats:styled-content>\n patients. Before weighting,\n TAVR<\/jats:styled-content>\n was associated with significantly shorter length of stay, more home discharges, and lower incidences of acute kidney injury, bleeding, and cardiogenic shock. Associations were consistent across Charlson Comorbidity Index, except for\n TAVR<\/jats:styled-content>\n being associated with greater length of stay reductions among patients with Charlson Comorbidity Index \u22652, compared with Charlson Comorbidity Index <2 (change in estimate \u22123.56 versus \u22122.61\u00a0days,\n P<\/jats:italic>\n =0.004). After weighting,\n TAVR<\/jats:styled-content>\n patients had significantly shorter length of stay (change in estimate \u22123.29\u00a0days, 95%\n CI<\/jats:styled-content>\n \u22123.82, \u22122.75) and lower odds of transfer to skilled nursing facility (odds ratio 0.34, 95%\n CI<\/jats:styled-content>\n 0.29, 0.41), acute kidney injury (odds ratio 0.55, 95%\n CI<\/jats:styled-content>\n 0.45, 0.68), bleeding (odds ratio 0.44, 95%\n CI<\/jats:styled-content>\n 0.37, 0.53), and cardiogenic shock (odds ratio 0.55, 95%\n CI<\/jats:styled-content>\n 0.33, 0.92), compared with\n SAVR<\/jats:styled-content>\n patients. Odds of permanent pacemaker implantation, transient ischemic attack\/stroke, vascular complications, and in\u2010hospital mortality were not significantly different.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n TAVR<\/jats:styled-content>\n may be preferred over\n SAVR<\/jats:styled-content>\n in high\u2010risk octogenarians because of shorter length of stay, better discharge disposition, and less acute kidney injury, and bleeding. All octogenarians may benefit more from\n TAVR<\/jats:styled-content>\n , irrespective of comorbidity burden, but additional research is needed to confirm our findings.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.118.011206","type":"journal-article","created":{"date-parts":[[2019,1,19]],"date-time":"2019-01-19T10:00:33Z","timestamp":1547892033000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["In\u2010Hospital Outcomes After Transcatheter Versus Surgical Aortic Valve Replacement in Octogenarians"],"prefix":"10.1161","volume":"8","author":[{"given":"Siyuan P.","family":"Sheng","sequence":"first","affiliation":[{"name":"University of North Carolina School of Medicine Chapel Hill NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula D.","family":"Strassle","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameer","family":"Arora","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill NC"},{"name":"Division of Cardiology University of North Carolina School of Medicine Chapel Hill NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhaval","family":"Kolte","sequence":"additional","affiliation":[{"name":"Division of Cardiology Massachusetts General Hospital Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cassandra J.","family":"Ramm","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of North Carolina School of Medicine Chapel Hill NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kranthi","family":"Sitammagari","sequence":"additional","affiliation":[{"name":"Department of Medicine Campbell University School of Osteopathic Medicine Lillington NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avirup","family":"Guha","sequence":"additional","affiliation":[{"name":"Heart and Vascular Center Ohio State Wexner Medical Center Columbus OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madhu B.","family":"Paladugu","sequence":"additional","affiliation":[{"name":"Department of Medicine Campbell University School of Osteopathic Medicine Lillington NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew A.","family":"Cavender","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of North Carolina School of Medicine Chapel Hill NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John P.","family":"Vavalle","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of North Carolina School of Medicine Chapel Hill NC"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69208-8"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2012-302265"},{"key":"e_1_3_1_4_2","unstructured":"Vincent GK Velkoff VA. 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