Healthcare burden of mixed aortic valve stenosis and insufficiency disease.

IF 3 4区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Journal of Medical Economics Pub Date : 2026-12-01 Epub Date: 2026-03-09 DOI:10.1080/13696998.2026.2635880

Ibrahim Sultan, Michael Ryan, Candace Gunnarsson, Godfred Marfo, Prashanth Vallabhajosyula

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引用次数: 0

Abstract

Objective: To compare mortality, healthcare utilization, and costs between patients with symptomatic and asymptomatic mixed aortic valve disease (MAVD).

Methods: We analyzed Optum United Health Care database for US patients with aortic insufficiency (AI) claims (2017-2024) and prior/concurrent aortic stenosis (AS) claims, requiring 12 months continuous enrollment. Patients with baseline aortic valve replacement (AVR) were excluded. Symptomatic MAVD (SMAVD) was defined as ≥2 baseline visits for heart failure, angina, dyspnea, or syncope. Outcomes included mortality, time to home health/skilled nursing facility (SNF), and annualized healthcare utilization and costs, analyzed using Cox proportional hazard and general linear models.

Results: Among 132,361 MAVD patients, 73.62% (n = 97,448) were symptomatic at diagnosis. Of initially asymptomatic patients, 58.94% became symptomatic within 5 years. Only 22% received AVR within 5 years. SMAVD patients had higher mortality (HR 1.48, 95% CI 1.44-1.53), home health utilization (HR 1.32, 95% CI 1.30-1.35), SNF admissions (HR 1.38, 95% CI 1.35-1.41), and $11,120 higher annual costs.

Conclusions: SMAVD patients experience significantly worse outcomes than asymptomatic patients. Early detection and timely interventions are critical to reducing MAVD's healthcare burden.

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主动脉瓣狭窄和不全混合性疾病的医疗负担。

目的：比较有症状和无症状混合性主动脉瓣疾病（MAVD）患者的死亡率、医疗保健利用和费用。方法：我们分析了Optum United Health Care数据库中2017-2024年美国主动脉功能不全（AI）患者和既往/并发主动脉狭窄（AS）患者的数据，需要连续入组12个月。排除基线主动脉瓣置换术（AVR）患者。症状性MAVD （SMAVD）定义为≥2次基线就诊，包括心力衰竭、心绞痛、呼吸困难或晕厥。结果包括死亡率、到家庭健康/熟练护理机构（SNF）的时间、年化医疗保健利用率和成本，并使用Cox比例风险模型和一般线性模型进行分析。结果：132,361例MAVD患者中，73.62% （n = 97,448）在诊断时出现症状。在最初无症状的患者中，58.94%的患者在5年内出现症状。只有22%的患者在5年内接受了AVR治疗。SMAVD患者的死亡率更高（HR 1.48, 95% CI 1.44-1.53），家庭健康利用率更高（HR 1.32, 95% CI 1.30-1.35）， SNF入院率更高（HR 1.38, 95% CI 1.35-1.41），年费用更高11120美元。结论：SMAVD患者的预后明显差于无症状患者。早期发现和及时干预对于减轻MAVD的医疗负担至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Medical Economics HEALTH CARE SCIENCES & SERVICES-MEDICINE, GENERAL & INTERNAL

CiteScore

4.50

自引率

4.20%

发文量

122

期刊介绍： Journal of Medical Economics'' mission is to provide ethical, unbiased and rapid publication of quality content that is validated by rigorous peer review. The aim of Journal of Medical Economics is to serve the information needs of the pharmacoeconomics and healthcare research community, to help translate research advances into patient care and be a leader in transparency/disclosure by facilitating a collaborative and honest approach to publication. Journal of Medical Economics publishes high-quality economic assessments of novel therapeutic and device interventions for an international audience