The impact of open native aortic valve replacement procedure on survival and costs in two hospitals: A multivariate analysis

Abstract

ABSTRACTObjective To compare the survival and costs of native aortic valve replacement by open approach in two hospitals.Methods We analyzed 1,472 hospital discharges from two hospitals between 2017 and 2021. We followed mean post-operative length of stay and survival at 30 days, one year and five years. The variables under study were sex, age, type of prosthesis, complexity, hospital, cost of the valve, date of intervention, discharge and exitus if present. A bivariate and a multivariate analysis were performed.Results The two hospitals have baseline characteristics with no significant differences. One of the hospitals had a higher mean unit price, in both biological (96%) and mechanical prostheses (11%) (p1); this higher mortality did not reach statistical significance in the multivariate analysis.In both hospitals, older age was associated with lower survival at one year (HR = 1.299 CI = 1.035–1.630) and at five years (HR = 1.228, 95%CI = 1.023–1.476). Greater complexity is associated with lower survival in all three periods.Conclusions Higher costs for open aortic heart valves does not lead to better survival outcomes. There is room for improvement in hospital management of these resources.KEYWORDS: Heart valve prosthesiscardiac surgerysutureless bioprosthesissurvival ratecost analysis Disclosure statementNo potential conflict of interest was reported by the author(s).Additional informationFundingThe author(s) reported there is no funding associated with the work featured in this article.Notes on contributorsRaquel Vázquez-MourelleRaquel Vázquez-Mourelle is a doctor in epidemiology and public healh and deputy directorate general in hospital management of Galician Health Service (Servicio Gallego de Salud- SERGAS), Spain.Gonzalo Rivas CostaGonzalo Rivas-Costa is the head of hospital management service of Galician Health Service (Servicio Gallego de Salud- SERGAS), Spain.Eduardo Carracedo-MartínezEduardo Carracedo-Martínez is a PhD epidemiology and public healh and a comunity pharmacist in Hospital of Santiago de Compostela (Servicio Gallego de Salud- SERGAS), Spain.Carmen Canedo RomeroCarmen Canedo Romero is the health proffesionals (doctors) with expertise in hospital care management of the Galician Health Service (Servicio Gallego de Salud- SERGAS), Spain.Jose Antonio Bravo RicoyJosé Antonio Bravo Ricoy is the health proffesionals (doctors) with expertise in hospital care management of the Galician Health Service (Servicio Gallego de Salud- SERGAS), Spain.