182 The Impact of Socioeconomic Status on the Outcomes of Transcatheter Aortic Valve Implantation (TAVI)

Abstract

The association between low socioeconomic status (SES) and poorer cardiovascular outcomes has been reported in previous studies(1). Australia is geographically diverse with a large majority of the population residing in rural and remote areas where access to healthcare is limited. We aimed to compare patient characteristics among patients stratified by low, middle and high SES groups undergoing Transcatheter Aortic Valve Implantation (TAVI). Data were prospectively collected on 463 patients from the TAVI-ACOR database between 2016 and 2019. The Index of Relative Socioeconomic Disadvantage (IRSD) score from the Australian Bureau of Statistics allowed stratification of patients into low (IRSD 1-4; n=157; 33.9%), middle (IRSD 5-7; n=104; 22.5%) and high (IRSD 8-10; n=202; 43.6%) SES groups (median IRSD score =7, IQR 4-9). Patients from high SES backgrounds were more likely to have private insurance compared with the low SES group (13.2% vs 23.1%; p=0.012) and had lower prevalence of diabetes (9.5% vs 11.5%; p=0.040). Society of Thoracic Surgery (STS) mortality risk scores did not vary significantly (p=0.67) between each SES group. There was no statistically significant difference between SES groups for hospital admission length (median 5 days, IQR 3-6; p=0.402) post-TAVI. Patients were followed 1-year post-TAVI, SES was not found to be an independent predictor of death (Figure 1). Lower SES was associated with greater rates of comorbidity in TAVI patients. However, low SES was not associated with a higher STS score or greater mortality.