LAUSR

Purpose Obesity is associated with several cardiovascular diseases including aortic valve stenosis. Studies have demonstrated a beneficial effect of obesity on patients with cardiovascular disease, deemed the “obesity paradox.” This paradox is also present in obese patients undergoing total aortic valve replacement (TAVR) when examining both short and long-term mortality rates, although the data is conflicting. We aim to investigate the effects of obesity on mortality, length of hospital stay, and rates of stroke and cardiogenic shock in patients undergoing TAVR. Methods We examined National Inpatient Sample (NIS) database from years 2011-14 for all hospital admissions, for TAVR with and without obesity. ICD-9 codes were utilized for selecting the study group. We compared baseline characteristics of the two groups using parametric and non-parametric tests for continuous variables and Chi-Squares test for dichotomous variables. Multivariate logistic regression was used to draw comparisons between incidence of cardiogenic shock, stroke,in-hospital mortality and length of stay(LOS). Our analysis adjusted for age, sex, race, payer, income quartiles, hospital location, region, size and teaching status. Multiple co-morbidities were also accounted for during our analysis (e.g. DM, CKD,HTN, history of CABG and PCI etc.). Results From 2007-2014, a total of 42268 patients were included in the aforementioned study group. 13.2% (5,572) of the study population had concomitant diagnosis of obesity. Study population with obesity was significantly younger (mean age 76.1yrs (TAVR w obesity)vs 81.9 yrs. (TAVR) p 0.05) was not statistically significant. Interestingly in-hospital mortality (OR 0.67, CI (0.20,0.44); p Conclusion This nation-wide study indicates that obese patients undergoing TAVR are at significantly higher risk for cardiogenic shock and longer LOS. Interestingly, our study also found the ‘obesity paradox’ to be valid in this study.