The Association of Economic Outcome and Geriatric Syndromes among Older Adults with Transcatheter Aortic Valve Replacement (TAVR)
**Background:** The association of geriatric syndromes and economic outcomes among patients who are undergoing transcatheter aortic valve replacement (TAVR) remains unknown. **Methods and Results:** A retrospective observational study using the National Inpatient Sample (NIS) from 2011 to 2014 was...
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| Format: | Article |
| Language: | English |
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Columbia Data Analytics, LLC
2020-10-01
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| Series: | Journal of Health Economics and Outcomes Research |
| Online Access: | https://doi.org/10.36469/jheor.2020.17423 |
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| author | Min Ji Kwak Rafia Rasu Robert O. Morgan Jessica Lee Nahid J. Rianon Holly M. Holmes Abhijeet Dhoble Dae Hyun Kim |
| author_facet | Min Ji Kwak Rafia Rasu Robert O. Morgan Jessica Lee Nahid J. Rianon Holly M. Holmes Abhijeet Dhoble Dae Hyun Kim |
| author_sort | Min Ji Kwak |
| collection | DOAJ |
| description | **Background:** The association of geriatric syndromes and economic outcomes among patients who are undergoing transcatheter aortic valve replacement (TAVR) remains unknown.
**Methods and Results:** A retrospective observational study using the National Inpatient Sample (NIS) from 2011 to 2014 was conducted with 7078 patients who were 65 years or older and underwent TAVR. The average hospital cost was US$58 703 (± SD 29 777) and length of stay (LOS) was 8.1 days (±7.20). The rates of delirium, dementia, and frailty were 8.0%, 6.1%, and 10.5%, respectively. From a multivariable generalized linear regression, delirium increased the cost by 31.5% (95% CI 25.41~37.92) and LOS by 70.3% (95% CI 60.20~83.38). Frailty increased the cost by 7.4% (95% CI 3.44~11.53) and the LOS by 22.6% (95% CI 15.15~30.55). Dementia had no significant association with either outcome. When the interactions of the geriatric syndromes were tested for association with the outcomes, delirium in the absence of dementia but presence of frailty showed the strongest association with cost (increase by 45.1%, 95% CI 26.45~66.45), and delirium in the absence of both dementia and frailty showed the strongest association with LOS (increase by 74.5%, 95% CI 62.71~87.13). When the average hospital cost and LOS were predicted using the model with interaction terms, patients with delirium and frailty (but without dementia) had the highest value (total hospital cost US$86 503 and LOS 14.9 days).
**Conclusion:** Among TAVR patients, delirium was significantly associated with increased hospital cost and LOS, and the association was significantly higher in the absence of dementia. The results of this study will be a great asset for health care providers and administrators in planning for efficient care strategy to lower health care expenditure in the hospital for older adults who underwent TAVR. |
| format | Article |
| id | doaj-art-46d94bcd42e3454facba7dcb25783fc3 |
| institution | Kabale University |
| issn | 2327-2236 |
| language | English |
| publishDate | 2020-10-01 |
| publisher | Columbia Data Analytics, LLC |
| record_format | Article |
| series | Journal of Health Economics and Outcomes Research |
| spelling | doaj-art-46d94bcd42e3454facba7dcb25783fc32025-02-10T16:13:00ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362020-10-0172The Association of Economic Outcome and Geriatric Syndromes among Older Adults with Transcatheter Aortic Valve Replacement (TAVR)Min Ji KwakRafia RasuRobert O. MorganJessica LeeNahid J. RianonHolly M. HolmesAbhijeet DhobleDae Hyun Kim**Background:** The association of geriatric syndromes and economic outcomes among patients who are undergoing transcatheter aortic valve replacement (TAVR) remains unknown. **Methods and Results:** A retrospective observational study using the National Inpatient Sample (NIS) from 2011 to 2014 was conducted with 7078 patients who were 65 years or older and underwent TAVR. The average hospital cost was US$58 703 (± SD 29 777) and length of stay (LOS) was 8.1 days (±7.20). The rates of delirium, dementia, and frailty were 8.0%, 6.1%, and 10.5%, respectively. From a multivariable generalized linear regression, delirium increased the cost by 31.5% (95% CI 25.41~37.92) and LOS by 70.3% (95% CI 60.20~83.38). Frailty increased the cost by 7.4% (95% CI 3.44~11.53) and the LOS by 22.6% (95% CI 15.15~30.55). Dementia had no significant association with either outcome. When the interactions of the geriatric syndromes were tested for association with the outcomes, delirium in the absence of dementia but presence of frailty showed the strongest association with cost (increase by 45.1%, 95% CI 26.45~66.45), and delirium in the absence of both dementia and frailty showed the strongest association with LOS (increase by 74.5%, 95% CI 62.71~87.13). When the average hospital cost and LOS were predicted using the model with interaction terms, patients with delirium and frailty (but without dementia) had the highest value (total hospital cost US$86 503 and LOS 14.9 days). **Conclusion:** Among TAVR patients, delirium was significantly associated with increased hospital cost and LOS, and the association was significantly higher in the absence of dementia. The results of this study will be a great asset for health care providers and administrators in planning for efficient care strategy to lower health care expenditure in the hospital for older adults who underwent TAVR.https://doi.org/10.36469/jheor.2020.17423 |
| spellingShingle | Min Ji Kwak Rafia Rasu Robert O. Morgan Jessica Lee Nahid J. Rianon Holly M. Holmes Abhijeet Dhoble Dae Hyun Kim The Association of Economic Outcome and Geriatric Syndromes among Older Adults with Transcatheter Aortic Valve Replacement (TAVR) Journal of Health Economics and Outcomes Research |
| title | The Association of Economic Outcome and Geriatric Syndromes among Older Adults with Transcatheter Aortic Valve Replacement (TAVR) |
| title_full | The Association of Economic Outcome and Geriatric Syndromes among Older Adults with Transcatheter Aortic Valve Replacement (TAVR) |
| title_fullStr | The Association of Economic Outcome and Geriatric Syndromes among Older Adults with Transcatheter Aortic Valve Replacement (TAVR) |
| title_full_unstemmed | The Association of Economic Outcome and Geriatric Syndromes among Older Adults with Transcatheter Aortic Valve Replacement (TAVR) |
| title_short | The Association of Economic Outcome and Geriatric Syndromes among Older Adults with Transcatheter Aortic Valve Replacement (TAVR) |
| title_sort | association of economic outcome and geriatric syndromes among older adults with transcatheter aortic valve replacement tavr |
| url | https://doi.org/10.36469/jheor.2020.17423 |
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