Mortality after aortic valve replacement: Results from a nationally representative database

Background. Nationally representative estimates of in-hospital mortality af ter aortic valve replacement are needed to evaluate whether results from Th e Society of Thoracic Surgeons National Cardiac Surgery Database are applic able to other institutions in the United States performing these procedures . Methods. Data from the 1994 Nationwide Inpatient Sample were used to estima te the patient characteristics and in-hospital mortality rates associated w ith aortic valve replacements performed in nonfederal hospitals in the Unit ed States. Procedural and hospital characteristics were examined for possib le associations with in-hospital mortality. Results. An estimated 46,397 aortic valve replacements were performed. In-h ospital mortality occurred in 4.3% of first-time isolated aortic valve repl acements and 6.4% overall. The highest quartile of procedure-specific hospi tal 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). Conclusions. The in-hospital mortality rates observed in this study are ver y similar to those reported from The Society of Thoracic Surgeons database. These data provide substantial evidence that results from The Society of T horacic Surgeons database are representative of those achieved at other ins titutions. However, procedure-specific hospital volume must be considered i n applying these results to individual institutions. (Ann Thorac Surg 2000; 70:1939-45) (C) 2000 by The Society of Thoracic Surgeons.