Selection of prosthetic aortic valves in the United States among elderly Medicare patients from 2006 to 2015
| Autor: | John Laschinger, Nilsa Loyo-Berrios, Rob Warnock, Dongyi Tony Du, Stephen McKean, Xiaoxiao Lu, Danica Marinac-Dabic |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
Prosthetic valve medicine.medical_specialty Treatment choices business.industry 030204 cardiovascular system & hematology medicine.disease Logistic regression Surgery 03 medical and health sciences 0302 clinical medicine 030228 respiratory system Aortic valve replacement Inclusion and exclusion criteria medicine Retrospective analysis Medicare part a Cardiology and Cardiovascular Medicine business Selection (genetic algorithm) |
| Zdroj: | The Journal of thoracic and cardiovascular surgery. |
| ISSN: | 1097-685X |
| Popis: | Both biological and mechanical prosthetic valves are treatment choices for aortic valve replacement. We aimed to characterize the selection of prosthetic aortic valves among elderly Medicare patients.This was a retrospective analysis of patients aged 65 years or older who underwent aortic valve replacement alone or in combination with other procedures in the 2006-2015 Medicare databases. Patients were continuously enrolled in Medicare Part A and B. We characterized the trends and regional variation of the selection of prosthetic valves. Multivariable logistic regression was used to evaluate the determinants that influenced the selection of prosthetic valves.During the study period, there were 272,921 Medicare patients aged 65 years or older who underwent aortic valve replacement and met the inclusion and exclusion criteria. The selection of mechanical aortic valves decreased from 32.0% in 2006 to 24.3% in 2015 (P .01). In comparison with 18.5% from northeastern states, 34.6% of patients from southern states selected mechanical valves (P .01). Major determinants of the selection of prosthetic valves include age, gender, region, hospital characteristics, and physician experience. Patients being older, male, living in the northeast region, operated on in a high-volume hospital, and by more experienced physicians were more likely to receive biological valves.A 24.1% decrease in the selection of mechanical aortic valves was observed among elderly Medicare patients from 2006 to 2015. A dramatic regional difference was observed in the choice of prosthetic valves across the nation. |
| Databáze: | OpenAIRE |
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