Abstract 15900: Impact of Age on Readmission Following Mitraclip; National Readmission Database

Abstract

Transcatheter mitral valve repair with the Mitraclip device has become a therapeutic option for patients with moderate to severe mitral regurgitation (MR) and high surgical risk. There are limited data evaluating Mitraclip outcomes in younger patients, although limited studies suggest decreased mortality in younger patients. As severe MR has increasing become recognized in younger patients, there is a need to investigate outcomes with Mitraclip in these subjects. Based on limited available data, our hypothesis was adverse clinical outcomes, including readmission, would be significantly lower among younger subjects following Mitraclip. The National Readmission Database (NRD) for 2018 and 2019 was queried to identify patients undergoing transcatheter mitral valve repair using ICD-10 procedure code ‘02UG3JZ’. Patients were stratified into 3 age groups: < 65, 65-80, and > 80 years of age (yoa) for comparison of readmission rates and risk factors. A total of 9742 who underwent Mitraclip were included in the study. The mean age of included subjects was 77 yoa, and 56 % were male. Approximately 16% had diabetes, 70% had hypertension, and 27% had chronic lung disease. Approximately 87% of subjects had Medicare coverage, while 3% had Medicaid, and 8% had private insurance. Approximately 90% of patients were cared for in 90% teaching hospitals. The overall rate of readmission following Mitraclip was 14%. While there was no difference in readmission by sex for subjects < 65 or > 80, there was a significant increase in readmission for women in comparison to men who were 65-80 yoa (15.8 vs. 12.4%, P < 0.01). There was a significant decrease in rate of readmission for subjects > 80% in 2019 in comparison to 2018 (13.1 vs. 15.5%, P = 0.03). There was significant increase in readmission to teaching hospitals in comparison to non-teaching hospitals for individuals < 65 (15.0 vs. 9.8%, P < 0.01). Rate of readmission was significantly higher for individuals > 80 and 65-80 yoa with chronic lung disease (17.7 vs 13.1%, P < 0.01). For all studied age groups, uncontrolled hypertension was associated with increased rate of readmission (P <0.02). Our studies suggest overall similar outcomes for younger patients undergoing Mitraclip in comparison to other populations.