Temporal Trends in Disease Severity and Predicted Surgical Risk at the Time of Referral for Echocardiography in Patients Diagnosed with Aortic Stenosis
Research output: Contribution to journal › Journal article › Research › peer-review
BACKGROUND: Calcific aortic stenosis (AS) is the most common underlying pathology in patients undergoing heart valve surgery, with an expected increasing prevalence among the aging population.
METHODS AND RESULTS: We identified the temporal trends in referral patterns, disease severity, and associated surgical risk among patients with AS between January 1, 1995 and December 31, 2012 at the Duke University Hospital. A total of 6103 patients had a finding of mild (n = 3303), moderate (n = 1648), or severe AS (n = 1152) in a native aortic valve. Overall presence of severe AS increased significantly over time (P = 0.009) with the most substantial increase occurring from 2010 and onward. Median age upon referral (P < 0.001) and attendant predicted surgical risk (P < 0.001) increased significantly in the observation period among patients with a finding of severe AS. Among patients with a finding of severe AS, the proportion of patients aged older than 80 years increased to 51.0% in the most recent time period (2010-2012) compared with 32.6% in the preceding time period (P < 0.001 for overall time trend). Similarly, the proportion of patients with a logistic EuroSCORE greater than 20% increased to 21.3% (2010-2012) from 12.1% (pre-2010).
CONCLUSIONS: Among patients referred for echocardiography to a high-volume tertiary hospital center, a significant increase in the prevalence of severe AS was observed over time. This trend occurred in parallel with increasing age and predicted surgical risk at referral. Health-care resource planning should account for an increasing number of patients in need of high-risk aortic valve replacements in the near future.
Original language | English |
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Journal | Critical Pathways in Cardiology |
Volume | 14 |
Issue number | 3 |
Pages (from-to) | 103-109 |
Number of pages | 7 |
ISSN | 1535-282X |
DOIs | |
Publication status | Published - Sep 2015 |
- Aged, Aged, 80 and over, Aortic Valve, Aortic Valve Stenosis, Calcinosis, Cohort Studies, Echocardiography, Female, Hospitals, High-Volume, Humans, Male, Middle Aged, Patient Selection, Referral and Consultation, Risk Assessment, Severity of Illness Index, Tertiary Care Centers, Time Factors
Research areas
ID: 162758083