11% of TAVR sites deliver below-average care, suggesting a ‘meaningful performance gap’
Many patients undergoing transcatheter aortic valve repair (TAVR) in the United States may be receiving below-average care, according to a new study published ahead of print in Circulation.
The study’s authors developed and validated a new performance measure for TAVR care using data from more than 52,000 patients. All patients were treated from 2015 to 2017. Data came from the STS/ACC TVT Registry, a collaboration of the Society of Thoracic Surgeons, American College of Cardiology, FDA and CMS.
“The broad goals of this performance measure were to serve as a national benchmark for quality-of-care monitoring and to support both local quality improvement efforts as well as national efforts to use quality rather than volume requirements to maintain TAVR programs,” wrote lead author Nimesh D. Desai, MD, PhD, a specialist in the division of cardiovascular surgery at Hospital of the University of Pennsylvania, and colleagues.
Taking a close look at both mortality rates and patient outcomes, the group determined that stroke, major bleeding events, acute kidney injury and moderate or severe peri-valvular regurgitation were the most effective complications to use when developing their performance measure. Based on their analysis, Desai et al. found that there was “significant site-level variation in quality of care in TAVR in the United States.”
Above-average care was found in 8% of U.S. TAVR sites, according to the group’s performance measure, and below-average care was found in 11%.
“These findings suggest that there is a meaningful performance gap in TAVR at a modest number of U.S. centers,” the authors wrote.
Desai and colleagues noted that their new metric is scheduled to be publicly reported as part of the STS/ACC TVT Registry beginning sometime in 2021.
Click here for the team’s full analysis. More information on the ongoing STS/ACC TVT Registry is available here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.