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311 Mental Illness and the Development of Postoperative Atrial Fibrillation in Transcatheter Aortic Valve Replacement Patients: Trends over Time

Published online by Cambridge University Press:  24 April 2023

Natalie Kolba
Affiliation:
Renaissance School of Medicine, Undergraduate Medical Education, Stony Brook University, Stony Brook, NY
Jennifer Morrone
Affiliation:
Renaissance School of Medicine, Undergraduate Medical Education, Stony Brook University, Stony Brook, NY
Julia Dokko
Affiliation:
Renaissance School of Medicine, Undergraduate Medical Education, Stony Brook University, Stony Brook, NY
Samantha Novotny
Affiliation:
Renaissance School of Medicine, Undergraduate Medical Education, Stony Brook University, Stony Brook, NY
Jie Yang
Affiliation:
Renaissance School of Medicine, Office of Dean, Stony Brook University
Vineet Tummala
Affiliation:
Renaissance School of Medicine, Undergraduate Medical Education, Stony Brook University, Stony Brook, NY
Sohaib Agha
Affiliation:
Department of Surgery, Stony Brook University School of Medicine, Stony Brook, NY
Ashutosh Yaligar
Affiliation:
Department of Surgery, Stony Brook University School of Medicine, Stony Brook, NY
Puja B. Parikh
Affiliation:
Department of Medicine, Stony Brook University School of Medicine, Stony Brook, NY
Aurora D. Pryor
Affiliation:
Department of Surgery, Stony Brook University School of Medicine, Stony Brook, NY
Henry J. Tannous
Affiliation:
Department of Surgery, Stony Brook University School of Medicine, Stony Brook, NY
A. Laurie Shroyer
Affiliation:
Department of Surgery, Stony Brook University School of Medicine, Stony Brook, NY
Thomas Bilfinger
Affiliation:
Department of Surgery, Stony Brook University School of Medicine, Stony Brook, NY
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Abstract

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OBJECTIVES/GOALS: The purpose of this retrospective cohort study was to evaluate the impact of mental illness on first-time transcatheter aortic valve replacement (TAVR) and repeat TAVR (viv-AVR) outcomes including postoperative atrial fibrillation (POAF/AFL), as well as trends over time. METHODS/STUDY POPULATION: Using de-identified data reports from the New York Statewide Planning and Research Cooperative System (SPARCS) database from 2005-2018, multivariate logistics models were used to predict endpoints including POAF, the Society of Cardiothoracic surgeon (STS) endpoint (MM), and 30-day readmission (READMIT) in patients with and without mental illness. The TAVR procedure was approved for high-risk patients after 2012, and intermediate-risk patients after 2016, indicting a need to analyze the two populations separately. Multivariate analysis was only conducted on the first-time TAVR patients because of the small n in the viv-TAVR population. RESULTS/ANTICIPATED RESULTS: After 2012, 13.05% (1,810/13,870) of patients undergoing TAVR and 20.83% (15/72) undergoing viv-TAVR were diagnosed with a mental illness before the procedure. After 2016, 15.59% (1,485/9,524) TAVR patients and 20.00% (11/55) viv-TAVR patients had a preoperative diagnosis of mental illness. Multivariate analysis showed that mentally ill patients did not have significant differences in rates of POAF, 30-day readmission, and 30-day composite outcomes when compared to patients without mental illnesses following TAVR procedures after 2012 and 2016. Patients with POAF after both 2012 and 2016 were significantly less likely to be mentally ill, Black, and Hispanic. DISCUSSION/SIGNIFICANCE: Of the mentally ill patients who underwent TAVR, there was no significant difference in short-term outcomes after 2012 vs. 2016, compared to patients without mental illnesses. The small number of mentally ill patients undergoing TAVR may point to provider bias as a contributor to this high selectivity, and further evaluation would be of clinical use.

Type
Precision Medicine/Health
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
© The Author(s), 2023. The Association for Clinical and Translational Science