Abstract 13012: Impact of End-Stage Renal Disease on Short-Term Outcomes Among Adults Undergoing Percutaneous Mitral Valve Repair

Abstract

Introduction: Patients with end-stage renal disease (ESRD) are predisposed to multiple complications following invasive and non-invasive procedures. With the recent introduction of percutaneous mitral valve repair (PMVR), there needs to be more data on ESRD patients' outcomes following such procedures. Our analysis aims to bridge data via national hospitalization records. Methods: We used de-identified data of adults(ages 18 and more) undergoing PMVR between 2016-2020 via the National Inpatient Sample. Patients were separated into two groups based on the presence of a diagnosis of ESRD. We excluded all other forms of Chronic kidney disease classifications from our control group. Differences in outcomes were studied via logistic regression models. Results: Between 2016-2020, a total of 24680 procedures of PMVR were performed in the United States that met our selection criteria. Among them, 1655 (6.7%) patients were reported with a diagnosis of ESRD, while 23025 (93.3%) were without any diagnosis of CKD or ESRD. Patients with ESRD consisted of a younger cohort (mean age 68.68 years) compared to the non-ESRD group (mean age 77.39 years, p<0.01). Furthermore, the ESRD group showed a higher mean Charlson Comorbidity Index Score (CCI) score (6.47) compared to the non-ESRD group (score of 2.20). Most procedures were conducted in Urban teaching centers (90.4% of non-ESRD patients and 93.4% of ESRD patients). ESRD patients recorded higher odds of sepsis (aOR 1.747, 95% CI 1.191-2.560, p<0.01), major bleeding (aOR 8.316, 95% CI 7.336-9.426, p<0.01), postprocedural respiratory failure (aOR 2.531, 95% CI 1.441-4.445, p<0.01), and mortality (aOR 2.109, 95% CI 1.513-2.940, p<0.01). The two groups showed no differences in acute myocardial infarction events (aOR 1.235, 95% CI 0.899-1.697, p=0.193) during their hospitalization for the procedure. Conclusions: Patients with ESRD experienced poorer outcomes following PMVR as they had higher odds of mortality, postprocedural respiratory failure, major bleeding, and sepsis. Thus, physicians must adequately address the potential complications with and without the procedure and closely monitor the post-operative progress.