Balloon Mitral Valvuloplasty in the United States: A 13-Year Perspective
Abstract Background Incidence and prevalence of mitral stenosis is declining in the US. We performed this study to determine recent trends in utilization, complications, mortality, length of stay, and cost associated with balloon mitral valvuloplasty. Methods Utilizing the nationwide inpatient sampl...
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| creator | Badheka, Apurva O., MD Shah, Neeraj, MD Ghatak, Abhijit, MD Patel, Nileshkumar J., MD Chothani, Ankit, MD Mehta, Kathan, MD Singh, Vikas, MD Patel, Nilay, MD Grover, Peeyush, MD Deshmukh, Abhishek, MD Panaich, Sidakpal S., MD Savani, Ghanshyambhai T., MD Bhalara, Vipulkumar, MD Arora, Shilpkumar, MD Rathod, Ankit, MD Desai, Harit, MD Kar, Saibal, MD Alfonso, Carlos, MD Palacios, Igor F., MD Grines, Cindy, MD Schreiber, Theodore, MD Rihal, Charanjit S., MD Makkar, Raj, MD Cohen, Mauricio G., MD O'Neill, William, MD de Marchena, Eduardo, MD |
| description | Abstract Background Incidence and prevalence of mitral stenosis is declining in the US. We performed this study to determine recent trends in utilization, complications, mortality, length of stay, and cost associated with balloon mitral valvuloplasty. Methods Utilizing the nationwide inpatient sample database from 1998 to 2010, we identified patients using the International Classification of Diseases, 9th Revision, Clinical Modification procedure code for “percutaneous valvuloplasty.” Patients ≥18 years of age with mitral stenosis were included. Patients with concomitant aortic, tricuspid, or pulmonic stenosis were excluded. Primary outcome included death and procedural complications. Results A total of 1308 balloon mitral valvuloplasties (weighted n = 6540) were analyzed. There was a 7.5% decrease in utilization of the procedure from 24.6 procedures/10 million population in 1998-2001 to 22.7 procedures/10 million population in 2008-2010 ( P for trend = .098). We observed a 15.9% overall procedural complication rate and 1.7% mortality rate. The procedural complication rates have increased in recent years ( P = .001), corresponding to increasing age and burden of comorbidities in patients. The mean cost per admission for balloon mitral valvuloplasty has gone up significantly over the 10 years, from $11,668 ± 1046 in 2001 to $23,651 ± 301 in 2010 ( P |
| doi_str_mv | 10.1016/j.amjmed.2014.05.015 |
| format | Article |
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We performed this study to determine recent trends in utilization, complications, mortality, length of stay, and cost associated with balloon mitral valvuloplasty. Methods Utilizing the nationwide inpatient sample database from 1998 to 2010, we identified patients using the International Classification of Diseases, 9th Revision, Clinical Modification procedure code for “percutaneous valvuloplasty.” Patients ≥18 years of age with mitral stenosis were included. Patients with concomitant aortic, tricuspid, or pulmonic stenosis were excluded. Primary outcome included death and procedural complications. Results A total of 1308 balloon mitral valvuloplasties (weighted n = 6540) were analyzed. There was a 7.5% decrease in utilization of the procedure from 24.6 procedures/10 million population in 1998-2001 to 22.7 procedures/10 million population in 2008-2010 ( P for trend = .098). We observed a 15.9% overall procedural complication rate and 1.7% mortality rate. The procedural complication rates have increased in recent years ( P = .001), corresponding to increasing age and burden of comorbidities in patients. The mean cost per admission for balloon mitral valvuloplasty has gone up significantly over the 10 years, from $11,668 ± 1046 in 2001 to $23,651 ± 301 in 2010 ( P <.001). Conclusions In a large cross-sectional study of balloon mitral valvuloplasty in the US, we have reported trends of decreasing overall utilization and increasing procedural complication rates and cost over a period of 13 years.</description><identifier>ISSN: 0002-9343</identifier><identifier>EISSN: 1555-7162</identifier><identifier>DOI: 10.1016/j.amjmed.2014.05.015</identifier><identifier>PMID: 24859718</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age Distribution ; Balloon ; Balloon Valvuloplasty - adverse effects ; Balloon Valvuloplasty - economics ; Balloon Valvuloplasty - statistics & numerical data ; Balloon Valvuloplasty - trends ; Comorbidity ; Complications ; Continental Population Groups - statistics & numerical data ; Cost ; Cross-Sectional Studies ; Databases, Factual ; Female ; Hospital Mortality ; Hospital stay ; Hospitalization - economics ; Humans ; Internal Medicine ; Length of Stay - statistics & numerical data ; Length of Stay - trends ; Male ; Medicaid ; Medicare ; Middle Aged ; Mitral valve ; Mitral Valve Stenosis - epidemiology ; Mitral Valve Stenosis - therapy ; Mortality ; United States - epidemiology ; Valvuloplasty</subject><ispartof>The American journal of medicine, 2014-11, Vol.127 (11), p.1126.e1-1126.e12</ispartof><rights>Elsevier Inc.</rights><rights>2014 Elsevier Inc.</rights><rights>Copyright © 2014 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c487t-280ba5522e1a9cabd32195eef986d71feda7b141b0e0abc0f849124740216fda3</citedby><cites>FETCH-LOGICAL-c487t-280ba5522e1a9cabd32195eef986d71feda7b141b0e0abc0f849124740216fda3</cites><orcidid>0000-0002-7246-7262</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S000293431400401X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24859718$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Badheka, Apurva O., MD</creatorcontrib><creatorcontrib>Shah, Neeraj, MD</creatorcontrib><creatorcontrib>Ghatak, Abhijit, MD</creatorcontrib><creatorcontrib>Patel, Nileshkumar J., MD</creatorcontrib><creatorcontrib>Chothani, Ankit, MD</creatorcontrib><creatorcontrib>Mehta, Kathan, MD</creatorcontrib><creatorcontrib>Singh, Vikas, MD</creatorcontrib><creatorcontrib>Patel, Nilay, MD</creatorcontrib><creatorcontrib>Grover, Peeyush, MD</creatorcontrib><creatorcontrib>Deshmukh, Abhishek, MD</creatorcontrib><creatorcontrib>Panaich, Sidakpal S., MD</creatorcontrib><creatorcontrib>Savani, Ghanshyambhai T., MD</creatorcontrib><creatorcontrib>Bhalara, Vipulkumar, MD</creatorcontrib><creatorcontrib>Arora, Shilpkumar, MD</creatorcontrib><creatorcontrib>Rathod, Ankit, MD</creatorcontrib><creatorcontrib>Desai, Harit, MD</creatorcontrib><creatorcontrib>Kar, Saibal, MD</creatorcontrib><creatorcontrib>Alfonso, Carlos, MD</creatorcontrib><creatorcontrib>Palacios, Igor F., MD</creatorcontrib><creatorcontrib>Grines, Cindy, MD</creatorcontrib><creatorcontrib>Schreiber, Theodore, MD</creatorcontrib><creatorcontrib>Rihal, Charanjit S., MD</creatorcontrib><creatorcontrib>Makkar, Raj, MD</creatorcontrib><creatorcontrib>Cohen, Mauricio G., MD</creatorcontrib><creatorcontrib>O'Neill, William, MD</creatorcontrib><creatorcontrib>de Marchena, Eduardo, MD</creatorcontrib><title>Balloon Mitral Valvuloplasty in the United States: A 13-Year Perspective</title><title>The American journal of medicine</title><addtitle>Am J Med</addtitle><description>Abstract Background Incidence and prevalence of mitral stenosis is declining in the US. We performed this study to determine recent trends in utilization, complications, mortality, length of stay, and cost associated with balloon mitral valvuloplasty. Methods Utilizing the nationwide inpatient sample database from 1998 to 2010, we identified patients using the International Classification of Diseases, 9th Revision, Clinical Modification procedure code for “percutaneous valvuloplasty.” Patients ≥18 years of age with mitral stenosis were included. Patients with concomitant aortic, tricuspid, or pulmonic stenosis were excluded. Primary outcome included death and procedural complications. Results A total of 1308 balloon mitral valvuloplasties (weighted n = 6540) were analyzed. There was a 7.5% decrease in utilization of the procedure from 24.6 procedures/10 million population in 1998-2001 to 22.7 procedures/10 million population in 2008-2010 ( P for trend = .098). We observed a 15.9% overall procedural complication rate and 1.7% mortality rate. The procedural complication rates have increased in recent years ( P = .001), corresponding to increasing age and burden of comorbidities in patients. The mean cost per admission for balloon mitral valvuloplasty has gone up significantly over the 10 years, from $11,668 ± 1046 in 2001 to $23,651 ± 301 in 2010 ( P <.001). Conclusions In a large cross-sectional study of balloon mitral valvuloplasty in the US, we have reported trends of decreasing overall utilization and increasing procedural complication rates and cost over a period of 13 years.</description><subject>Age Distribution</subject><subject>Balloon</subject><subject>Balloon Valvuloplasty - adverse effects</subject><subject>Balloon Valvuloplasty - economics</subject><subject>Balloon Valvuloplasty - statistics & numerical data</subject><subject>Balloon Valvuloplasty - trends</subject><subject>Comorbidity</subject><subject>Complications</subject><subject>Continental Population Groups - statistics & numerical data</subject><subject>Cost</subject><subject>Cross-Sectional Studies</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Hospital stay</subject><subject>Hospitalization - economics</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Length of Stay - trends</subject><subject>Male</subject><subject>Medicaid</subject><subject>Medicare</subject><subject>Middle Aged</subject><subject>Mitral valve</subject><subject>Mitral Valve Stenosis - epidemiology</subject><subject>Mitral Valve Stenosis - therapy</subject><subject>Mortality</subject><subject>United States - epidemiology</subject><subject>Valvuloplasty</subject><issn>0002-9343</issn><issn>1555-7162</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUFv1DAQhS0EokvhHyDkI5eEGcdOYg5IpQKK1KpIpVU5WY4zEQ7eZGsnK-2_J9G2Fy6cRqN5857mG8beIuQIWH7oc7vtt9TmAlDmoHJA9YxtUCmVVViK52wDACLThSxO2KuU-qUFrcqX7ETIWukK6w27-GxDGMeBX_kp2sDvbNjPYdwFm6YD9wOffhO_HfxELb-Z7ETpIz_jWGS_yEb-g2LakZv8nl6zF50Nid481lN2-_XLz_OL7PL62_fzs8vMybqaMlFDY5USgtBqZ5u2EKgVUafrsq2wo9ZWDUpsgMA2DrpaahSykiCw7FpbnLL3R99dHB9mSpPZ-uQoBDvQOCezXK51VQlRL1J5lLo4phSpM7votzYeDIJZGZreHBmalaEBZRaGy9q7x4S5WWdPS0_QFsGno4CWO_eeoknO0-Co9XGBYdrR_y_hXwMX_OCdDX_oQKkf5zgsDA2aJAyYm_WP6xtRAkjA--IvUtOYBw</recordid><startdate>20141101</startdate><enddate>20141101</enddate><creator>Badheka, Apurva O., MD</creator><creator>Shah, Neeraj, MD</creator><creator>Ghatak, Abhijit, MD</creator><creator>Patel, Nileshkumar J., MD</creator><creator>Chothani, Ankit, MD</creator><creator>Mehta, Kathan, MD</creator><creator>Singh, Vikas, MD</creator><creator>Patel, Nilay, MD</creator><creator>Grover, Peeyush, MD</creator><creator>Deshmukh, Abhishek, MD</creator><creator>Panaich, Sidakpal S., MD</creator><creator>Savani, Ghanshyambhai T., MD</creator><creator>Bhalara, Vipulkumar, MD</creator><creator>Arora, Shilpkumar, MD</creator><creator>Rathod, Ankit, MD</creator><creator>Desai, Harit, MD</creator><creator>Kar, Saibal, MD</creator><creator>Alfonso, Carlos, MD</creator><creator>Palacios, Igor F., MD</creator><creator>Grines, Cindy, MD</creator><creator>Schreiber, Theodore, MD</creator><creator>Rihal, Charanjit S., MD</creator><creator>Makkar, Raj, MD</creator><creator>Cohen, Mauricio G., MD</creator><creator>O'Neill, William, MD</creator><creator>de Marchena, Eduardo, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7246-7262</orcidid></search><sort><creationdate>20141101</creationdate><title>Balloon Mitral Valvuloplasty in the United States: A 13-Year Perspective</title><author>Badheka, Apurva O., MD ; Shah, Neeraj, MD ; Ghatak, Abhijit, MD ; Patel, Nileshkumar J., MD ; Chothani, Ankit, MD ; Mehta, Kathan, MD ; Singh, Vikas, MD ; Patel, Nilay, MD ; Grover, Peeyush, MD ; Deshmukh, Abhishek, MD ; Panaich, Sidakpal S., MD ; Savani, Ghanshyambhai T., MD ; Bhalara, Vipulkumar, MD ; Arora, Shilpkumar, MD ; Rathod, Ankit, MD ; Desai, Harit, MD ; Kar, Saibal, MD ; Alfonso, Carlos, MD ; Palacios, Igor F., MD ; Grines, Cindy, MD ; Schreiber, Theodore, MD ; Rihal, Charanjit S., MD ; Makkar, Raj, MD ; Cohen, Mauricio G., MD ; O'Neill, William, MD ; de Marchena, Eduardo, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c487t-280ba5522e1a9cabd32195eef986d71feda7b141b0e0abc0f849124740216fda3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Age Distribution</topic><topic>Balloon</topic><topic>Balloon Valvuloplasty - adverse effects</topic><topic>Balloon Valvuloplasty - economics</topic><topic>Balloon Valvuloplasty - statistics & numerical data</topic><topic>Balloon Valvuloplasty - trends</topic><topic>Comorbidity</topic><topic>Complications</topic><topic>Continental Population Groups - statistics & numerical data</topic><topic>Cost</topic><topic>Cross-Sectional Studies</topic><topic>Databases, Factual</topic><topic>Female</topic><topic>Hospital Mortality</topic><topic>Hospital stay</topic><topic>Hospitalization - economics</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Length of Stay - trends</topic><topic>Male</topic><topic>Medicaid</topic><topic>Medicare</topic><topic>Middle Aged</topic><topic>Mitral valve</topic><topic>Mitral Valve Stenosis - epidemiology</topic><topic>Mitral Valve Stenosis - therapy</topic><topic>Mortality</topic><topic>United States - epidemiology</topic><topic>Valvuloplasty</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Badheka, Apurva O., MD</creatorcontrib><creatorcontrib>Shah, Neeraj, MD</creatorcontrib><creatorcontrib>Ghatak, Abhijit, MD</creatorcontrib><creatorcontrib>Patel, Nileshkumar J., MD</creatorcontrib><creatorcontrib>Chothani, Ankit, MD</creatorcontrib><creatorcontrib>Mehta, Kathan, MD</creatorcontrib><creatorcontrib>Singh, Vikas, MD</creatorcontrib><creatorcontrib>Patel, Nilay, MD</creatorcontrib><creatorcontrib>Grover, Peeyush, MD</creatorcontrib><creatorcontrib>Deshmukh, Abhishek, MD</creatorcontrib><creatorcontrib>Panaich, Sidakpal S., MD</creatorcontrib><creatorcontrib>Savani, Ghanshyambhai T., MD</creatorcontrib><creatorcontrib>Bhalara, Vipulkumar, MD</creatorcontrib><creatorcontrib>Arora, Shilpkumar, MD</creatorcontrib><creatorcontrib>Rathod, Ankit, MD</creatorcontrib><creatorcontrib>Desai, Harit, MD</creatorcontrib><creatorcontrib>Kar, Saibal, MD</creatorcontrib><creatorcontrib>Alfonso, Carlos, MD</creatorcontrib><creatorcontrib>Palacios, Igor F., MD</creatorcontrib><creatorcontrib>Grines, Cindy, MD</creatorcontrib><creatorcontrib>Schreiber, Theodore, MD</creatorcontrib><creatorcontrib>Rihal, Charanjit S., MD</creatorcontrib><creatorcontrib>Makkar, Raj, MD</creatorcontrib><creatorcontrib>Cohen, Mauricio G., MD</creatorcontrib><creatorcontrib>O'Neill, William, MD</creatorcontrib><creatorcontrib>de Marchena, Eduardo, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Badheka, Apurva O., MD</au><au>Shah, Neeraj, MD</au><au>Ghatak, Abhijit, MD</au><au>Patel, Nileshkumar J., MD</au><au>Chothani, Ankit, MD</au><au>Mehta, Kathan, MD</au><au>Singh, Vikas, MD</au><au>Patel, Nilay, MD</au><au>Grover, Peeyush, MD</au><au>Deshmukh, Abhishek, MD</au><au>Panaich, Sidakpal S., MD</au><au>Savani, Ghanshyambhai T., MD</au><au>Bhalara, Vipulkumar, MD</au><au>Arora, Shilpkumar, MD</au><au>Rathod, Ankit, MD</au><au>Desai, Harit, MD</au><au>Kar, Saibal, MD</au><au>Alfonso, Carlos, MD</au><au>Palacios, Igor F., MD</au><au>Grines, Cindy, MD</au><au>Schreiber, Theodore, MD</au><au>Rihal, Charanjit S., MD</au><au>Makkar, Raj, MD</au><au>Cohen, Mauricio G., MD</au><au>O'Neill, William, MD</au><au>de Marchena, Eduardo, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Balloon Mitral Valvuloplasty in the United States: A 13-Year Perspective</atitle><jtitle>The American journal of medicine</jtitle><addtitle>Am J Med</addtitle><date>2014-11-01</date><risdate>2014</risdate><volume>127</volume><issue>11</issue><spage>1126.e1</spage><epage>1126.e12</epage><pages>1126.e1-1126.e12</pages><issn>0002-9343</issn><eissn>1555-7162</eissn><abstract>Abstract Background Incidence and prevalence of mitral stenosis is declining in the US. We performed this study to determine recent trends in utilization, complications, mortality, length of stay, and cost associated with balloon mitral valvuloplasty. Methods Utilizing the nationwide inpatient sample database from 1998 to 2010, we identified patients using the International Classification of Diseases, 9th Revision, Clinical Modification procedure code for “percutaneous valvuloplasty.” Patients ≥18 years of age with mitral stenosis were included. Patients with concomitant aortic, tricuspid, or pulmonic stenosis were excluded. Primary outcome included death and procedural complications. Results A total of 1308 balloon mitral valvuloplasties (weighted n = 6540) were analyzed. There was a 7.5% decrease in utilization of the procedure from 24.6 procedures/10 million population in 1998-2001 to 22.7 procedures/10 million population in 2008-2010 ( P for trend = .098). We observed a 15.9% overall procedural complication rate and 1.7% mortality rate. The procedural complication rates have increased in recent years ( P = .001), corresponding to increasing age and burden of comorbidities in patients. The mean cost per admission for balloon mitral valvuloplasty has gone up significantly over the 10 years, from $11,668 ± 1046 in 2001 to $23,651 ± 301 in 2010 ( P <.001). Conclusions In a large cross-sectional study of balloon mitral valvuloplasty in the US, we have reported trends of decreasing overall utilization and increasing procedural complication rates and cost over a period of 13 years.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24859718</pmid><doi>10.1016/j.amjmed.2014.05.015</doi><orcidid>https://orcid.org/0000-0002-7246-7262</orcidid></addata></record> |
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| subjects | Age Distribution Balloon Balloon Valvuloplasty - adverse effects Balloon Valvuloplasty - economics Balloon Valvuloplasty - statistics & numerical data Balloon Valvuloplasty - trends Comorbidity Complications Continental Population Groups - statistics & numerical data Cost Cross-Sectional Studies Databases, Factual Female Hospital Mortality Hospital stay Hospitalization - economics Humans Internal Medicine Length of Stay - statistics & numerical data Length of Stay - trends Male Medicaid Medicare Middle Aged Mitral valve Mitral Valve Stenosis - epidemiology Mitral Valve Stenosis - therapy Mortality United States - epidemiology Valvuloplasty |
| title | Balloon Mitral Valvuloplasty in the United States: A 13-Year Perspective |
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