Diagnosis related group and outcomes followingtranscatheter aortic valve implantation

BACKGROUND. The association between Medicare Severity-Diagnosis Related Group (DRG) and early and intermediate-Termoutcomes in patients undergoing transcatheter aortic valve implantation (TAVI) has not been well studied. We aimed to assess therelationship between DRG and 30-day and 1-year mortality in patients undergoing TAVI. METHODS. The study population included289 patients with severe symptomatic AS who underwent TAVI from December 2015 to June 2018 at an academic tertiary caremedical center. Patients were categorized as DRG 266 or DRG 267, specifying TAVI with or without major complication orcomorbidities respectively. RESULTS. Of the 289 patients, 182 patients (63.0%) were classified under DRG 267 and 107 patients(37.0%) under DRG 266. The DRG 266 group had longer hospital lengths of stay and higher rates of discharge to a skilled nursingfacility. While rates of in-hospital and 30-day mortality were similar in both DRG groups, the DRG 266 group had higher 1-year all-cause mortality (26.2% vs 8.8%, p<0.001). In multivariable analysis, serum creatinine (OR 1.42, 95%CI 1.05-1.93) was the onlyindependent predictor of 1-year mortality in the DRG 266 group while atrial fibrillation (OR 3.04, 95%CI 1.03-8.92) was the onlyindependent predictor of mortality in the DRG 267 group. CONCLUSIONS. In this prospective registry of patients undergoing TAVI,while rates of in-hospital and 30-day mortality were similar in both DRG 266 and 267 groups, the DRG 266 group had higher 1-yearall-cause mortality. Distinct predictors of mortality in each DRG group exist.