Aortic Stenosis Staging Helps Predict TAVR Outcomes

MedicalResearch.com Interview with:
JOÃO L. CAVALCANTE, MD, FASE, FACC, FSCCT, FSCMR
Director, Cardiac MRI and Structural CT Labs
Director, Cardiovascular Imaging Research Core Lab
Minneapolis Heart Institute
Abbott Northwestern Hospital
Minneapolis, MN, 55407

MIHO FUKUI MD
Division of Cardiovascular Diseases, Department of Internal Medicine, Heart & Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota

MedicalResearch.com: What is the background for this study?

Response: Recent study by Généreux et al (1), using the Placement of Aortic Transcatheter Valves (PARTNER) 2A and 2B data, provided the first framework of a staging system for severe aortic stenosis (AS) that quantifies the extent of structural and functional cardiac change associated with AS and importantly its association with 1-year mortality in patients receiving either surgical or transcatheter AVR (TAVR):

  • Stage 0: No other cardiac damage;
  • Stage 1: LV damage as defined by presence of LV hypertrophy, severe LV diastolic, or LV systolic dysfunction;
  • Stage 2: Left atrium or mitral valve damage or dysfunction;
  • Stage 3: Pulmonary artery vasculature or tricuspid valve damage or dysfunction; and
  • Stage 4: right ventricular damage.

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Serious Mental Illness Raises Risk of 30 Day Readmission

MedicalResearch.com Interview with:

Hayley D. Germack PHD, MHS, RN Assistant Professor, School of Nursing University of Pittsburgh

Dr. Germack

Hayley D. Germack PHD, MHS, RN
Assistant Professor, School of Nursing
University of Pittsburgh

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: As nurse scientists, we repeatedly witness the impact of having a serious mental illness (i.e. schizophrenia, bipolar disorder, and major depression disorder) on patients’ inpatient and discharge experience. As health services researchers, we know how to make use of large secondary data to illuminate our firsthand observations.

In 2016, Dr. Hanrahan and colleagues (https://www.sciencedirect.com/science/article/pii/S0163834316301347) published findings of a secondary data analysis from a large urban hospital system that found 1.5 to 2.4 greater odds of readmission for patients with an  serious mental illness diagnosis compared to those without. We decided to make use of the AHRQ’s HCUP National Readmissions Database to illuminate the magnitude of this relationship using nationally representative data. We found that even after controlling for clinical, demographic, and hospital factors, that patients with SMI have nearly 2 times greater odds of 30-day readmission.  Continue reading