Temporal trends in disease severity and predicted surgical risk at the time of referral for echocardiography in patients diagnosed with aortic stenosis

Mads Ersboll, Zainab Samad, Fawaz Al Enezi, Joseph Kisslo, Phillip Schulte, Linda K. Shaw, Lars Køber, J. Kevin Harrison, Thomas Bashore, Matthew Brennan, Eric J. Velazquez

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

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 languageEnglish (US)
Pages (from-to)103-109
Number of pages7
JournalCritical Pathways in Cardiology
Volume14
Issue number3
DOIs
StatePublished - Sep 1 2015
Externally publishedYes

    Fingerprint

Keywords

  • Aortic stenosis
  • Aortic valve replacement
  • Echocardiography
  • Health services research
  • High-risk populations

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Ersboll, M., Samad, Z., Al Enezi, F., Kisslo, J., Schulte, P., Shaw, L. K., Køber, L., Harrison, J. K., Bashore, T., Brennan, M., & Velazquez, E. J. (2015). Temporal trends in disease severity and predicted surgical risk at the time of referral for echocardiography in patients diagnosed with aortic stenosis. Critical Pathways in Cardiology, 14(3), 103-109. https://doi.org/10.1097/HPC.0000000000000048