The impact of age and XXXX on outcomes after isolated aortic valve replacement for @entity472 .

@entity1 @entity337 @entity472 @entity221 @entity884
OBJECTIVES: This study examines outcomes in a national sample of @entity1 undergoing isolated aortic valve replacement (AVR) for @entity472 , with particular focus on advanced-age @entity1 and those with extreme @entity221 ( @entity221 ). METHODS: Data were obtained from the Nationwide Inpatient Sample and included all @entity1 undergoing AVRs performed from January 1, 2006 to December 31, 2008. @entity1 with major concomitant cardiac procedures, as well as those aged, 20 years, and those with @entity884 or @entity337 without @entity472 , were excluded from analysis. The analysis included 13,497 @entity1 . @entity1 were stratified by age and further stratified by All @entity1 Refined Diagnosis Related Group @entity221 into mild/moderate, major, and extreme subgroups. RESULTS: Overall in-hospital mortality was 2.96% (n=399); in-hospital mortality for the >= 80-year-old group (n=139, 4.78%) was significantly higher than the 20- to 49-year-old (n=9, 0.84%, P<0.001) or 50- to 79-year-old (n=251, 2.64%, P<0.001) groups. In-hospital mortality was significantly higher in the extreme @entity221 group (n=296, 15.33%) than in the minor/moderate (n=22, 0.35%, P<0.001) and major @entity221 groups (n=81, 1.51%, P<0.001). Median in-hospital costs in the mild/moderate, major, and extreme @entity221 strata were  29,202.08,  36,035.13, and  57,572.92, respectively. CONCLUSION: In the minor, moderate, and major @entity221 groups, in-hospital mortality and costs are low regardless of age; these groups represent >85% of @entity1 undergoing isolated AVR for @entity472 . Conversely, in @entity1 classified as having extreme @entity221 , surgical therapy is associated with exceedingly high inpatient mortality, low home discharge rates, and high resource utilization, particularly in the advanced age group.
