Clinical outcomes and direct costs after transcatheter aortic valve implantation in French centres: a longitudinal study of 1332 patients using a national database.
To describe the clinical outcomes of patients undergoing transcatheter aortic valve implantation (TAVI) and to determine the direct costs before and after TAVI.



A nationwide longitudinal study using data extracted from the French Hospital Information System.



all patients who underwent TAVI between 1 January 2010 and 31 December 2010. Period of follow-up: 12 months preceding TAVI to 36 months after. End-points: mortality, morbidity and total costs of acute and rehabilitation care from the perspective of the hospital.



A total of 1332 patients (mean age: 82.0 ± 7.2 years; 50.2% men) were identified. The mean hospitalization length of stay was 13.5 ± 9.3 days. The intrahospital mortality from any cause was 7.9% during the index hospitalization, 8.8% at 30 days, 14.8% at 6 months, 18.4% at 1 year, 24.8% at 2 years and 32.3% at 3 years. The mean number of hospital stays per patient was 4.79 the year preceding TAVI and 4.11 the year after. The cumulated number of hospital stays at 2 and 3 years post-TAVI was 6.88 and 9.69, respectively. The mean hospitalization costs were 14 665€ the year preceding, 26 575€ for the index procedure and 12 308€ the year after TAVI. The cumulated hospitalization costs per patient at 3 years after TAVI were 22 110€ for acute hospitalizations and 5689€ for rehabilitation.



Mortality at 3 years is consistent with other published studies. After TAVI, hospitalization stays in both acute and rehabilitation settings, and the associated costs do not appear to be reduced compared with the year preceding TAVI. The total cost for patients undergoing TAVI is substantial at 3 years.
Hospices Civils De Lyon, Délégation à la Recherche Clinique et à l'Innovation, Cellule Innovation/UMR-CNRS 5510/MATEIS, Lyon, France armoiryxa@gmail.com.|University of Warwick, Warwick medical school, Division of Health Sciences, Coventry, England.
Xavier
X
Armoiry
Service de Chirurgie Cardio-thoracique et Transplantation, Hôpital Cardio-thoracique Louis Pradel, Lyon-Bron, France.
Jean-François
JF
Obadia
Département de Cardiologie, Hôpital Xavier Bichat, Faculté Paris Diderot, DHU Fire, Paris, France.
Bernard
B
Iung
Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Lyon, France.|Université Claude Bernard Lyon 1, Health Services and Performance Research Lab, Villeurbanne, France.
Stephanie
S
Polazzi
Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Lyon, France.|Université Claude Bernard Lyon 1, Health Services and Performance Research Lab, Villeurbanne, France.|Center for Surgery and Public Health, Brigham and Women's Hospital-Harvard Medical School, Boston, MA, USA.
Antoine
A
Duclos
D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000191:economics* / Q000209:etiology / Q000601:surgery*; D016208:Databases, Factual; D004180:Direct Service Costs; D005260:Female; D005602:France; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D065467:Transcatheter Aortic Valve Replacement / Q000191:economics*; D016896:Treatment Outcome
Aortic stenosis; Cost; Epidemiology; French medico-administrative databases; Transcatheter aortic valve