{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:50:48Z","timestamp":1753887048799,"version":"3.41.2"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,11,15]]},"abstract":"\n Background<\/jats:title>\n The trends in outcomes in patients who undergo transcatheter aortic valve replacement are well described in the literature. Some of these trends are driven by the decreasing risk profile of patients because of changing indications for transcatheter aortic valve replacement. We aimed to evaluate these trends in different age groups and quantify how much of these trends are driven by changes in procedural characteristics.<\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Using the National Inpatient Sample from 2012 to 2018, we identified 204\u2009230 adult patients who underwent transfemoral aortic valve replacement. The study's primary objective was to evaluate the changes in age\u2010based trends in in\u2010hospital mortality driven by changes in procedural characteristics over time. The secondary objectives were to evaluate similar trends in cardiac and noncardiac complications and resource use. Univariate and multivariate linear and logistic regression were used to obtain effect sizes. From 2012 to 2018, in\u2010hospital mortality decreased from 1.8% to 0.79% in the age group 18 to 64\u2009years, from 3.8% to 1.6% in the age group 65 to 80\u2009years, and from 5.3% to 1.5% in the age group >80\u2009years (\n P<\/jats:italic>\n trend<0.01 for all age groups); these trends remained statistically significant on adjusted analysis except in patients aged 18 to 64\u2009years. The other outcomes also showed variable trends over time. Length of stay, cost, and early discharge rates improved even after adjusting for comorbidities, which is likely attributable to improvement in procedural characteristics.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The changes in outcomes related to transcatheter aortic valve replacement are partly driven by changing patient risk profiles over time, but procedural characteristics have likely contributed to these trends in all age groups.<\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.122.026812","type":"journal-article","created":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T10:35:40Z","timestamp":1667471740000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Role of Changing Procedural Characteristics Versus Changing Risk Profile in Age\u2010Based Trends of Outcomes in Patients With Transfemoral Transcatheter Aortic Valve Replacement From 2012 to 2018: A Nationwide Analysis"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9710-7610","authenticated-orcid":false,"given":"Muddasir","family":"Ashraf","sequence":"first","affiliation":[{"name":"Aurora Cardiovascular and Thoracic Services Aurora Sinai\/Aurora St. Luke\u2019s Medical Centers, Advocate Aurora Health Milwaukee WI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7478-4739","authenticated-orcid":false,"given":"Ryan M.","family":"Carnahan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology The University of Iowa College of Public Health Iowa City IA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"doi-asserted-by":"publisher","key":"e_1_3_1_2_2","DOI":"10.1056\/NEJMoa1008232"},{"doi-asserted-by":"publisher","key":"e_1_3_1_3_2","DOI":"10.1056\/NEJMoa1103510"},{"doi-asserted-by":"publisher","key":"e_1_3_1_4_2","DOI":"10.1016\/j.jacc.2014.02.556"},{"doi-asserted-by":"publisher","key":"e_1_3_1_5_2","DOI":"10.1056\/NEJMoa1400590"},{"doi-asserted-by":"publisher","key":"e_1_3_1_6_2","DOI":"10.1056\/NEJMoa1514616"},{"doi-asserted-by":"publisher","key":"e_1_3_1_7_2","DOI":"10.1056\/NEJMoa1700456"},{"doi-asserted-by":"publisher","key":"e_1_3_1_8_2","DOI":"10.1056\/NEJMoa1814052"},{"doi-asserted-by":"publisher","key":"e_1_3_1_9_2","DOI":"10.1056\/NEJMoa1816885"},{"unstructured":"Agency for Healthcare Research and Quality . HCUPS. Available at: https:\/\/www.hcup\u2010us.ahrq.gov\/nisoverview.jsp. Accessed March 19 2022.","key":"e_1_3_1_10_2"},{"unstructured":"Agency for Healthcare Research and Quality . Healthcare Cost and Utilization Project user support: Elixhauser comorbidity software for ICD\u20109\u2010CM. Available at: https:\/\/www.hcup\u2010us.ahrq.gov\/toolssoftware\/comorbidity\/comorbidity.jsp#download. Accessed March 19 2022.","key":"e_1_3_1_11_2"},{"unstructured":"Agency for Healthcare Research and Quality . Healthcare Cost and Utilization Project user support: tools archive for Elixhauser comorbidity software refined for ICD\u201010\u2010CM. Available at: https:\/\/www.hcup\u2010us.ahrq.gov\/toolssoftware\/comorbidityicd10\/comorbidity_icd10_archive.jsp. Accessed March 26 2022.","key":"e_1_3_1_12_2"},{"unstructured":"Agency for Healthcare Research and Quality . Healthcare Cost and Utilization Project: user support: cost\u2010to\u2010charge ratio for inpatient files. 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