title: Trends of Hospitalizations in the United States from 2000 to 2012 of Patients >60 Years With Aortic Valve Disease.
abstract: In recent years, there has been an increased emphasis on the diagnosis and treatment of valvular heart disease and, in particular, aortic stenosis. This has been driven in part by the development of innovative therapeutic options and by an aging patient population. We hypothesized an increase in the number of hospitalizations and the economic burden associated with aortic valve disease (AVD). Using Nationwide Inpatient Sample from 2000 to 2012, AVD-related hospitalizations were identified using International Classification of Diseases, Ninth Revision, Clinical Modification, code 424.1, as the principal discharge diagnosis. Overall AVD hospitalizations increased by 59% from 2000 to 2012. This increase was most significant in patients >80 years and those with higher burden of co-morbidities. The most frequent coexisting conditions were hypertension, heart failure, renal failure, anemia, and diabetes. Overall inhospital mortality of patients hospitalized for AVD was 3.8%, which significantly decreased from 4.5% in 2000 to 3.5% in 2012 (p <0.001). The largest decrease in mortality was seen in the subgroup of patients who had heart failure (62% reduction), higher burden of co-morbidities (58% reduction), and who were >80 years (53% reduction). There was a substantial increase in the cost of hospitalization in the last decade from $31,909 to $38,172 (p <0.001). The total annual cost for AVD hospitalization in the United States increased from $1.3 billion in 2001 to $2.1 billion in 2011 and is expected to increase to nearly 3 billion by 2020. The last decade has witnessed a significant increase in hospitalizations for AVD in the United States. The associated decrease in inhospital mortality and increase in the cost of hospitalization have considerably increased the economic burden on the public health system.
authors.affiliation: Cardiovascular Division, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Apurva O
authors.initials: AO
authors.lastname: Badheka
authors.affiliation: Cardiovascular Division, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Vikas
authors.initials: V
authors.lastname: Singh
authors.affiliation: Cardiovascular Division, Staten Island University Hospital, Staten Island, New York.
authors.forename: Nileshkumar J
authors.initials: NJ
authors.lastname: Patel
authors.affiliation: Cardiovascular Division, Mount Sinai St Luke's Roosevelt Hospital, New York, New York.
authors.forename: Shilpkumar
authors.initials: S
authors.lastname: Arora
authors.affiliation: Cardiovascular Division, Saint Peter's University Hospital, New Brunswick, New Jersey.
authors.forename: Nilay
authors.initials: N
authors.lastname: Patel
authors.affiliation: Cardiovascular Division, Tulane School of Public Health and Tropical Medicine, New Orleans, Los Angeles.
authors.forename: Badal
authors.initials: B
authors.lastname: Thakkar
authors.affiliation: Cardiovascular Division, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Sunny
authors.initials: S
authors.lastname: Jhamnani
authors.affiliation: Cardiovascular Division, Icahn School of Public Health at Mount Sinai, New York, New York.
authors.forename: Sadip
authors.initials: S
authors.lastname: Pant
authors.affiliation: Cardiovascular Division, University of Louisville, Louisville, Kentucky.
authors.forename: Ankit
authors.initials: A
authors.lastname: Chothani
authors.affiliation: Cardiovascular Division, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Conrad
authors.initials: C
authors.lastname: Macon
authors.affiliation: Cardiovascular Division, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Sidakpal S
authors.initials: SS
authors.lastname: Panaich
authors.affiliation: Cardiovascular Division, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Jay
authors.initials: J
authors.lastname: Patel
authors.affiliation: Cardiovascular Division, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Sohilkumar
authors.initials: S
authors.lastname: Manvar
authors.affiliation: Cardiovascular Division, Detroit Medical Center, Detroit, Michigan.
authors.forename: Chirag
authors.initials: C
authors.lastname: Savani
authors.affiliation: Cardiovascular Division, Tulane School of Public Health and Tropical Medicine, New Orleans, Los Angeles.
authors.forename: Parth
authors.initials: P
authors.lastname: Bhatt
authors.affiliation: Cardiovascular Division, Tulane School of Public Health and Tropical Medicine, New Orleans, Los Angeles.
authors.forename: Vinaykumar
authors.initials: V
authors.lastname: Panchal
authors.affiliation: Cardiovascular Division, Jersey City Medical Center, Jersey City, New Jersey.
authors.forename: Neil
authors.initials: N
authors.lastname: Patel
authors.affiliation: Cardiovascular Division, Jersey City Medical Center, Jersey City, New Jersey.
authors.forename: Achint
authors.initials: A
authors.lastname: Patel
authors.affiliation: Cardiovascular Division, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Darshan
authors.initials: D
authors.lastname: Patel
authors.affiliation: Cardiovascular Division, Mayo Clinic, Rochester, Minnesota.
authors.forename: Sopan
authors.initials: S
authors.lastname: Lahewala
authors.affiliation: Cardiovascular Division, Mayo Clinic, Rochester, Minnesota.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Deshmukh
authors.affiliation: Cardiovascular Division, MedStar Washington Hospital Center, Washington, District of Columbia.
authors.forename: Tamam
authors.initials: T
authors.lastname: Mohamad
authors.affiliation: Cardiovascular Division, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Abeel A
authors.initials: AA
authors.lastname: Mangi
authors.affiliation: Cardiovascular Division, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Michael
authors.initials: M
authors.lastname: Cleman
authors.affiliation: Cardiovascular Division, Yale School of Medicine, New Haven, Connecticut. Electronic address: apurva_badheka@yahoo.com.
authors.forename: John K
authors.initials: JK
authors.lastname: Forrest
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000628:therapy; D000082882:Bicuspid Aortic Valve Disease; D017281:Cost of Illness; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000191:economics / Q000401:mortality / Q000628:therapy*; D006349:Heart Valve Diseases / Q000175:diagnosis* / Q000191:economics / Q000401:mortality / Q000628:therapy*; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization / Q000191:economics / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States