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Impact of social deprivation on outcome following transcatheter aortic valve implantation (TAVI)

Mohee, Kevin, Protty, Majd B., Whiffen, Tony, Chase, Alexander and Smith, Dave 2019. Impact of social deprivation on outcome following transcatheter aortic valve implantation (TAVI). Open Heart 6 (2) , e001089. 10.1136/openhrt-2019-001089

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Objectives We sought to evaluate whether socioeconomic status influences outcome after first-time transcatheter aortic valve implantation (TAVI). Method This is a single-centre study carried out in Swansea, South West Wales, UK between 5 November 2009 and 10 June 2018. Data included age, gender, domiciliary postal code, comorbidities, complications post-TAVI, length of stay, follow-up time and survival status. The Welsh Index of Multiple Deprivation, 2014 was used to stratify cases by level of social deprivation according to domiciliary postal codes. Results Study population was 387 patients of whom 213 (54.8%) were men with mean age ±SD of 82.8±8.3 years. Patients, who were less deprived (296 (76.4%)), were more likely to be older (83.5±7.9 vs 80.4±9.3, p<0.05) and to be married (83.2% vs 69.7%, p<0.05). Conversely, ‘more deprived’ patients (91 (23.6%)) were more likely to have a longer stay in hospital as compared with patients in the ‘less deprived group’ (29.6±32.7 days vs 21.3±21.1 days, p<0.05). However, 30-day, 1-year and 3-year survival/mortality rates were similar across all socioeconomic levels. Conclusions This is the first study in which social deprivation has been investigated as a risk factor for mortality in a high-risk group of patients with severe aortic stenosis undergoing TAVI. Residing in a ‘more deprived’ area in South West Wales is not associated with adverse outcome following TAVI but patients who are ‘more deprived’ tend to stay longer in hospital compared with patients who are ‘less deprived’.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: BMJ Publishing Group: Open Access / BMJ Publishing Group
ISSN: 2053-3624
Funders: N/A
Date of First Compliant Deposit: 1 May 2020
Date of Acceptance: 18 November 2019
Last Modified: 04 May 2020 14:30

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