Investigator Spotlight: Fabio Lima, MD

Advance-CTR

Date January 22, 2020

Congratulations, Dr. Lima!

Fabio Lima, MD, was recently published in Catheterization and Cardiovascular Interventions for his research on readmission of high-risk patients with valve repair using the Nationwide Readmissions Database.

Dr. Lima consulted with the Research Design, Epidemiology, and Biostatistics Core of Advance-CTR prior to submission to extract, analyze, and understand the data.

The Study

"Thirty-Day Readmissions After Transcatheter Versus Surgical Mitral Valve Repair in High-Risk Patients with Mitral Regurgitation: Analysis of the 2014-2015 Nationwide Readmissions Databases" (Lima, et al., Catheterization and Cardiovascular Interventions, 2019)

We analyzed the rates, causes, and predictors of 30-day, non-elective readmissions among 8,912 patients undergoing transcatheter and surgical mitral valve repair (national estimate 17,806 patients), from the 2014-2015 Nationwide Readmissions Database.

Approximately 1-in-10 patients were readmitted within 30-days, 50% of which were due to cardiac conditions. Among cardiac conditions, heart failure and arrhythmias were the leading causes for readmission. Independent predictors of 30-day readmission were largely non-modifiable and varied between the two patient groups. Predictors of readmission among the transcatheter treated group included anemia and fluid and electrolyte disorders. Whereas predictors of readmission among the surgical group included age, cardiac comorbidities, chronic kidney disease, and index hospital length of stay.

These data provide the most contemporary assessment of 30-day readmissions following mitral valve repair in the post-MitraClip approval period in the US.

“ These data provide the most contemporary assessment of 30-day readmissions following mitral valve repair in the post-MitraClip approval period in the US. ”

What's Next

We hope to expand on this groundwork and pursue further studies in transcatheter cardiac interventions. The Nationwide Readmissions Database is an immense resource for inpatient data throughout the US and we plan on using it again in the near future for other projects. Other datasets of interest to us include the National Cardiovascular Data Registry from the American College of Cardiology and the US Centers for Medicare and Medicaid Services Medicare Provider Analysis and Review Datasets.

How the Advance-CTR Biostatistics Core Helped

The Biostatistics Core team was very supportive and motivated in helping us answer our study questions. During our time working together, the statistical team provided us with confidence in their ability to navigate the Nationwide Readmissions Database and perform advanced statistical tests to the data they extracted from it. Also, they promptly responded to questions about the data reports they provided. They were a great team and we appreciate their help.