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179 Baseline Characteristics and In-Hospital Outcomes of TAVI in Ontario: Data From The Cardiac Care Network of Ontario (CCN) TAVI Registry
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Canadian Journal of Cardiology Volume 28 2012
changes in intra- and post-operative complications and mortality, importantly post-operative in-hospital mortality has decreased over time (54%). Length of stay has also decreased slightly over time. CONCLUSIONS: The CCN TAVI registry captures observations from a multicenter experience in Ontario that reflects real-life practice. Patients resemble the population studied in clinical trials, and this has not changed over time. Procedural success has remained high and complications associated with this new technology have decreased. The Ontario experience has demonstrated that TAVI can be done safely and effectively in an appropriately selected patient population.
179 BASELINE CHARACTERISTICS AND IN-HOSPITAL OUTCOMES OF TAVI IN ONTARIO: DATA FROM THE CARDIAC CARE NETWORK OF ONTARIO (CCN) TAVI REGISTRY DM Purdham, MK Natarajan, DT Ko, EA Cohen, C Feindel, K Kingsbury Toronto, Ontario BACKGROUND: Transcatheter aortic valve implantation (TAVI)
has emerged as a treatment for many severe symptomatic aortic stenosis patients who cannot tolerate conventional aortic valve surgery. In landmark clinical trials, TAVI was demonstrated to be effective in select patient populations. It is unknown who the patients receiving this intervention are in real-world practice and how this is evolving over time in Ontario. METHODS: The Cardiac Care Network of Ontario (CCN) maintains a registry of completed TAVI cases done at each of the 8 programs in Ontario. This voluntary registry contains clinical information on patients who have accessed TAVI through health Canada’s special access program since January 2007. A third party audit of 10% of patient charts was done in September 2011. Clinical characteristics were analyzed from the CCN TAVI registry for patients from January 18, 2007- March 23, 2012. To understand the temporal trends, We divided the cohort of registry patients into two groups: The first half of the patients were compared with the second half of the patients completed to compare patient selection and procedural safety and effectiveness changes over time and analyzed using Fischer’s exact test for significance. RESULTS: There were 542 TAVI procedures captured in the registry in the time period analyzed. The mean age was 81.99 ⫾7.48years, with 43% of patients being 85 or older and 46.5% of patients were female. There was a high burden of comorbid conditions (see Table 1). Patient eligibility criteria were not significantly different between the first and second cohorts. Logistic EuroScore averaged 14.99 in the first half of patients and 13.89 in the second, this was not significantly different. The ratio of transfemoral/transapical approach increased from 1.82 in the first half to 3.23 in the second. Successful valve deployment was achieved in 94.8% and 93% of the time, in the first and second cohorts respectively. There were no significant
Canadian Cardiovascular Society (CCS) CCS093 Oral BRAIN OUTCOMES FOLLOWING CARDIAC ARREST: HOW ABOUT VACCINATION? Sunday, October 28, 2012 Featured Research 182 THE BURDEN OF HOSPITALIZED STROKE IN CANADA S Dai, A Bienek, P Walsh, A Wielgosz, H Morrison Ottawa, Ontario
Hospitalizations and mortality for stroke have been declining. However, stroke remains a leading cause of death and disability for Canadians. This study provides an overall picture of the burden of hospitalized stroke in Canada. METHODS: Acute care hospital separations from the most recent three fiscal years (2007/08 to 2009/10) with a primary diagnosis of stroke (ICD-10-CA: I60-I69) were identified. The number of stroke hospitalizations, average length of stay (LOS), and discharge dispositions, by age, gender, and province/territory were calculated using IBM/Cognos Data Cubes. RESULTS: The number of stroke hospitalizations remained steady over the three years. The proportion by gender was similar, with males accounting for 51.7% of stroke hospitalizations in 2007/08, 52.3% in 2008/09, and 52.2% in 2009/10. There BACKGROUND:
Canadian Journal of Cardiology Volume 28 2012
changes in intra- and post-operative complications and mortality, importantly post-operative in-hospital mortality has decreased over time (54%). Length of stay has also decreased slightly over time. CONCLUSIONS: The CCN TAVI registry captures observations from a multicenter experience in Ontario that reflects real-life practice. Patients resemble the population studied in clinical trials, and this has not changed over time. Procedural success has remained high and complications associated with this new technology have decreased. The Ontario experience has demonstrated that TAVI can be done safely and effectively in an appropriately selected patient population.
179 BASELINE CHARACTERISTICS AND IN-HOSPITAL OUTCOMES OF TAVI IN ONTARIO: DATA FROM THE CARDIAC CARE NETWORK OF ONTARIO (CCN) TAVI REGISTRY DM Purdham, MK Natarajan, DT Ko, EA Cohen, C Feindel, K Kingsbury Toronto, Ontario BACKGROUND: Transcatheter aortic valve implantation (TAVI)
has emerged as a treatment for many severe symptomatic aortic stenosis patients who cannot tolerate conventional aortic valve surgery. In landmark clinical trials, TAVI was demonstrated to be effective in select patient populations. It is unknown who the patients receiving this intervention are in real-world practice and how this is evolving over time in Ontario. METHODS: The Cardiac Care Network of Ontario (CCN) maintains a registry of completed TAVI cases done at each of the 8 programs in Ontario. This voluntary registry contains clinical information on patients who have accessed TAVI through health Canada’s special access program since January 2007. A third party audit of 10% of patient charts was done in September 2011. Clinical characteristics were analyzed from the CCN TAVI registry for patients from January 18, 2007- March 23, 2012. To understand the temporal trends, We divided the cohort of registry patients into two groups: The first half of the patients were compared with the second half of the patients completed to compare patient selection and procedural safety and effectiveness changes over time and analyzed using Fischer’s exact test for significance. RESULTS: There were 542 TAVI procedures captured in the registry in the time period analyzed. The mean age was 81.99 ⫾7.48years, with 43% of patients being 85 or older and 46.5% of patients were female. There was a high burden of comorbid conditions (see Table 1). Patient eligibility criteria were not significantly different between the first and second cohorts. Logistic EuroScore averaged 14.99 in the first half of patients and 13.89 in the second, this was not significantly different. The ratio of transfemoral/transapical approach increased from 1.82 in the first half to 3.23 in the second. Successful valve deployment was achieved in 94.8% and 93% of the time, in the first and second cohorts respectively. There were no significant
Canadian Cardiovascular Society (CCS) CCS093 Oral BRAIN OUTCOMES FOLLOWING CARDIAC ARREST: HOW ABOUT VACCINATION? Sunday, October 28, 2012 Featured Research 182 THE BURDEN OF HOSPITALIZED STROKE IN CANADA S Dai, A Bienek, P Walsh, A Wielgosz, H Morrison Ottawa, Ontario
Hospitalizations and mortality for stroke have been declining. However, stroke remains a leading cause of death and disability for Canadians. This study provides an overall picture of the burden of hospitalized stroke in Canada. METHODS: Acute care hospital separations from the most recent three fiscal years (2007/08 to 2009/10) with a primary diagnosis of stroke (ICD-10-CA: I60-I69) were identified. The number of stroke hospitalizations, average length of stay (LOS), and discharge dispositions, by age, gender, and province/territory were calculated using IBM/Cognos Data Cubes. RESULTS: The number of stroke hospitalizations remained steady over the three years. The proportion by gender was similar, with males accounting for 51.7% of stroke hospitalizations in 2007/08, 52.3% in 2008/09, and 52.2% in 2009/10. There BACKGROUND: