Age-Based Outcomes in Patients Who Underwent Septal Reduction Therapy

Abstract

There are no national data on age-based outcomes of septal reduction therapy. Using the National Inpatient Sample, we included all adult patients who underwent septal myectomy (SM) or alcohol septal ablation (ASA) from 2005 to 2019. The primary objective was to evaluate the in-hospital mortality and new permanent pacemaker (PPM) placement after SM and ASA in 3 age groups. In total, 9,564 patients underwent SM and 5,084 underwent ASA. Compared with the age group 18 to 39years, the odds of in-hospital mortality after SM were similar in age group 40 to 64years and 4.46 times higher than in age group ≥65years; the higher mortality in the older group was explained by higher co-morbidity burden on the risk-adjusted analysis. Furthermore, compared with age group 18 to 39years, the odds of new PPM placement after SM were higher in the age groups 40 to 64years and ≥65years, despite the risk adjustment (adjusted odds ratio [AOR] 3.17, 95% confidence interval [CI] 1.33 to 7.58 and AOR 4.39, 95% CI 1.78 to 10.8, respectively). The odds of in-hospital mortality after ASA were similar in age groups 65 to 79years and 18 to 64years. However, the odds of in-hospital mortality were higher in the age group ≥80years than in the age group 18 to 64years, although this difference were not present after risk adjustment. The odds of new PPM after ASA were higher for the age groups 65 to 79years and ≥80years than age group 18 to 64years, despite the risk adjustment (AOR 1.78, 95% CI 1.22 to 2.60 and AOR 3.10, 95% CI 2.09 to 6.57, respectively). Finally, we also estimated these absolute risks in different age groups. In conclusion, this national data will inform health care providers to better understand the aged-based risks of outcomes after septal reduction therapy.