Impact of gender on in-hospital mortality and 90-day readmissions in patients undergoing transcatheter edge-to-edge mitral valve repair: Analysis from the National Readmission Database.

Abstract

BACKGROUND\nPatients undergoing transcatheter edge-to-edge mitral valve repair (TEER) carry a high risk of rehospitalization due to disease, procedure, patient, hospital, and system related factors.\n\n\nAIMS\nWe aimed to explore the impact of gender on in-hospital mortality and 90-day readmissions in patients undergoing TEER.\n\n\nMETHODS\nWe utilized the National Readmission Database from 2012 to 2018 to identify individuals who underwent TEER for mitral regurgitation. Gender-based differences in in-hospital mortality and 90-day readmissions were explored using multivariable logistic regression models.\n\n\nRESULTS\nBetween 2012 and 2018, an estimated 21,415 TEER procedural hospitalizations were identified, of which 9893 (46.2%) were in women and 11,522 (53.8%) were in men. Compared with men, women were older, from a lower socioeconomic status but had a lower co-morbidity burden. In-hospital mortality rate during the index hospitalization was similar in women and men (2.1% vs. 2.1%, p\xa0=\xa00.908). Ninety-day all-cause and heart failure readmission rates were significantly higher in women compared to men (30.2% vs. 25.4%; p\u2009<\u20090.001 and 28.1% vs. 23.9%; p\xa0=\xa00.020 respectively). In a multivariable analysis, women had 36% greater odds of 90-day readmission compared to men (adjusted odds ratio [aOR] 1.36, 95% CI: 1.22-1.52; p\u2009<\u20090.001). Trend analysis revealed no significant improvement in rates of 90-day readmission during the observation period for men or women (p\u2009=\xa00.245, p\u2009=\xa00.429, respectively).\n\n\nCONCLUSIONS\nFollowing TEER, there has been no significant improvement in 90-day readmission rates between 2012 and 2018. Female gender is associated with higher 90-day all-cause and heart failure readmission rates.