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Record W4413657264 · doi:10.1016/j.jacadv.2025.102107

Incremental Cost and Length of Stay Associated With Complications of Transcatheter Aortic Valve Replacement

2025· article· en· W4413657264 on OpenAlexaff
Steven D. Culler, Matthew R. Reynolds, Aaron D. Kugelmass, Marc Katz, April W. Simon, David J. Cohen

Bibliographic record

VenueJACC Advances · 2025
Typearticle
Languageen
FieldMedicine
TopicCardiac Valve Diseases and Treatments
Canadian institutionsSeneca Polytechnic
Fundersnot available
KeywordsMedicineValve replacementCardiologyAortic valve replacementAortic valveInternal medicineStenosis

Abstract

fetched live from OpenAlex

BACKGROUND: Transcatheter aortic valve replacement (TAVR) has become the leading form of aortic valve replacement, with nearly 100,000 annual procedures in the United States. However, the impact of complications on hospital costs is not well understood. OBJECTIVES: The purpose of this study was to quantify the additional hospital resource use and costs associated with TAVR complications. METHODS: Medicare Provider Analysis and Review file from fiscal year 2020 identified 66,893 beneficiaries undergoing TAVR. International Classification of Diseases-10th-Clinical Modification diagnostic and procedure codes were used to identify complications and hospital costs were calculated using cost-to-charge ratios. Multivariable regression estimated the incremental cost and length of stay (LOS) associated with complications. RESULTS: In 2020, 31.1% of the 66,893 Medicare beneficiaries who underwent a TAVR experienced one or more complications. The mean cost of a TAVR hospitalization was $54,988 ± $26,744 and the mean LOS was 3.1 ± 4.5 days. Patients who experience any of the complications increased costs by $15,377 and incremental LOS by 2.8 days compared to those not experiencing complications. After adjustments for patient risk factors, the incremental cost of complications was $12,953. Surgical aortic valve replacement ($42,924), acute renal failure requiring dialysis ($34,606), and in-hospital mortality ($25,307) had the highest risk-adjusted costs. Complications accounted for $320 million in additional costs, representing 8.7% of the total hospital cost for Medicare TAVR patients. CONCLUSIONS: In contemporary practice, approximately one in 3 Medicare TAVR patients experience serious complications, substantially increasing hospital resource use. Despite improvements in TAVR outcomes and efficiency, additional cost savings can be achieved through complication mitigation.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.009
Threshold uncertainty score0.216

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.012
GPT teacher head0.339
Teacher spread0.327 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations1
Published2025
Admission routes1
Has abstractyes

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