The Impact of Malnutrition on Perioperative Ischemic Stroke in Transcatheter Aortic Valve Replacement (TAVR): A Retrospective Cohort Study of the National Inpatient Sample
ABSTRACT Background and Aims Ischemic stroke is a serious risk for patients undergoing transcatheter aortic valve replacement (TAVR). The relationship between malnutrition and post‐TAVR ischemic stroke remains unclear. This study investigates this association using the National Inpatient Sample (NIS...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-05-01
|
| Series: | Health Science Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/hsr2.70860 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850043967442255872 |
|---|---|
| author | Haowei Li Guangzhi Cong Xueping Ma Bo Shi Congyan Ye Rui Yan Shizhe Fu Kairu Wang Shaobin Jia Jingjing Wang |
| author_facet | Haowei Li Guangzhi Cong Xueping Ma Bo Shi Congyan Ye Rui Yan Shizhe Fu Kairu Wang Shaobin Jia Jingjing Wang |
| author_sort | Haowei Li |
| collection | DOAJ |
| description | ABSTRACT Background and Aims Ischemic stroke is a serious risk for patients undergoing transcatheter aortic valve replacement (TAVR). The relationship between malnutrition and post‐TAVR ischemic stroke remains unclear. This study investigates this association using the National Inpatient Sample (NIS) data. Methods A retrospective observational study was conducted using NIS data from 2012 to 2021. We included patients who underwent TAVR and were diagnosed with malnutrition based on ICD‐9 and ICD‐10 codes. Patients under 18 years, with a history of preoperative stroke, with both ischemic and hemorrhagic strokes, or with incomplete data were excluded. Logistic regression was performed to evaluate the association between malnutrition and ischemic stroke, adjusting for potential confounders. Sensitivity analyses included stratified analysis and propensity score matching. Results Among 364,580 TAVR patients, 10,415 (2.86%) were diagnosed with malnutrition. Malnourished patients were older (78.04 vs. 77.40), predominantly white (85.69%), and had a higher incidence of ischemic stroke (11.47% vs. 7.25%, p < 0.001). After adjusting for common ischemic stroke risk factors, malnutrition was significantly associated with an increased risk of ischemic stroke (aOR: 1.51; 95% CI: 1.31–1.74). This association remained significant in the propensity‐matched cohort. Subgroup analyses consistently showed associations between malnutrition and stroke risk across various demographic and clinical factors. Time trend analysis showed no significant difference in the annual incidence of perioperative ischemic stroke between malnourished patients with or without cerebral embolic protection devices (p = 0.439). Conclusion Malnutrition is associated with a higher risk of ischemic stroke following TAVR, highlighting the need for targeted interventions. |
| format | Article |
| id | doaj-art-a5dabc1b19d44e8896468c2ea8d43410 |
| institution | DOAJ |
| issn | 2398-8835 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Health Science Reports |
| spelling | doaj-art-a5dabc1b19d44e8896468c2ea8d434102025-08-20T02:55:06ZengWileyHealth Science Reports2398-88352025-05-0185n/an/a10.1002/hsr2.70860The Impact of Malnutrition on Perioperative Ischemic Stroke in Transcatheter Aortic Valve Replacement (TAVR): A Retrospective Cohort Study of the National Inpatient SampleHaowei Li0Guangzhi Cong1Xueping Ma2Bo Shi3Congyan Ye4Rui Yan5Shizhe Fu6Kairu Wang7Shaobin Jia8Jingjing Wang9Institute of Medical Sciences General Hospital of Ningxia Medical University Ningxia Yinchuan ChinaInstitute of Medical Sciences General Hospital of Ningxia Medical University Ningxia Yinchuan ChinaInstitute of Medical Sciences General Hospital of Ningxia Medical University Ningxia Yinchuan ChinaInstitute of Medical Sciences General Hospital of Ningxia Medical University Ningxia Yinchuan ChinaInstitute of Medical Sciences General Hospital of Ningxia Medical University Ningxia Yinchuan ChinaInstitute of Medical Sciences General Hospital of Ningxia Medical University Ningxia Yinchuan ChinaInstitute of Medical Sciences General Hospital of Ningxia Medical University Ningxia Yinchuan ChinaInstitute of Medical Sciences General Hospital of Ningxia Medical University Ningxia Yinchuan ChinaInstitute of Medical Sciences General Hospital of Ningxia Medical University Ningxia Yinchuan ChinaInstitute of Medical Sciences General Hospital of Ningxia Medical University Ningxia Yinchuan ChinaABSTRACT Background and Aims Ischemic stroke is a serious risk for patients undergoing transcatheter aortic valve replacement (TAVR). The relationship between malnutrition and post‐TAVR ischemic stroke remains unclear. This study investigates this association using the National Inpatient Sample (NIS) data. Methods A retrospective observational study was conducted using NIS data from 2012 to 2021. We included patients who underwent TAVR and were diagnosed with malnutrition based on ICD‐9 and ICD‐10 codes. Patients under 18 years, with a history of preoperative stroke, with both ischemic and hemorrhagic strokes, or with incomplete data were excluded. Logistic regression was performed to evaluate the association between malnutrition and ischemic stroke, adjusting for potential confounders. Sensitivity analyses included stratified analysis and propensity score matching. Results Among 364,580 TAVR patients, 10,415 (2.86%) were diagnosed with malnutrition. Malnourished patients were older (78.04 vs. 77.40), predominantly white (85.69%), and had a higher incidence of ischemic stroke (11.47% vs. 7.25%, p < 0.001). After adjusting for common ischemic stroke risk factors, malnutrition was significantly associated with an increased risk of ischemic stroke (aOR: 1.51; 95% CI: 1.31–1.74). This association remained significant in the propensity‐matched cohort. Subgroup analyses consistently showed associations between malnutrition and stroke risk across various demographic and clinical factors. Time trend analysis showed no significant difference in the annual incidence of perioperative ischemic stroke between malnourished patients with or without cerebral embolic protection devices (p = 0.439). Conclusion Malnutrition is associated with a higher risk of ischemic stroke following TAVR, highlighting the need for targeted interventions.https://doi.org/10.1002/hsr2.70860cerebral embolic protectionischemic strokemalnutritiontranscatheter aortic valve replacement |
| spellingShingle | Haowei Li Guangzhi Cong Xueping Ma Bo Shi Congyan Ye Rui Yan Shizhe Fu Kairu Wang Shaobin Jia Jingjing Wang The Impact of Malnutrition on Perioperative Ischemic Stroke in Transcatheter Aortic Valve Replacement (TAVR): A Retrospective Cohort Study of the National Inpatient Sample Health Science Reports cerebral embolic protection ischemic stroke malnutrition transcatheter aortic valve replacement |
| title | The Impact of Malnutrition on Perioperative Ischemic Stroke in Transcatheter Aortic Valve Replacement (TAVR): A Retrospective Cohort Study of the National Inpatient Sample |
| title_full | The Impact of Malnutrition on Perioperative Ischemic Stroke in Transcatheter Aortic Valve Replacement (TAVR): A Retrospective Cohort Study of the National Inpatient Sample |
| title_fullStr | The Impact of Malnutrition on Perioperative Ischemic Stroke in Transcatheter Aortic Valve Replacement (TAVR): A Retrospective Cohort Study of the National Inpatient Sample |
| title_full_unstemmed | The Impact of Malnutrition on Perioperative Ischemic Stroke in Transcatheter Aortic Valve Replacement (TAVR): A Retrospective Cohort Study of the National Inpatient Sample |
| title_short | The Impact of Malnutrition on Perioperative Ischemic Stroke in Transcatheter Aortic Valve Replacement (TAVR): A Retrospective Cohort Study of the National Inpatient Sample |
| title_sort | impact of malnutrition on perioperative ischemic stroke in transcatheter aortic valve replacement tavr a retrospective cohort study of the national inpatient sample |
| topic | cerebral embolic protection ischemic stroke malnutrition transcatheter aortic valve replacement |
| url | https://doi.org/10.1002/hsr2.70860 |
| work_keys_str_mv | AT haoweili theimpactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample AT guangzhicong theimpactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample AT xuepingma theimpactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample AT boshi theimpactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample AT congyanye theimpactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample AT ruiyan theimpactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample AT shizhefu theimpactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample AT kairuwang theimpactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample AT shaobinjia theimpactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample AT jingjingwang theimpactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample AT haoweili impactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample AT guangzhicong impactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample AT xuepingma impactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample AT boshi impactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample AT congyanye impactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample AT ruiyan impactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample AT shizhefu impactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample AT kairuwang impactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample AT shaobinjia impactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample AT jingjingwang impactofmalnutritiononperioperativeischemicstrokeintranscatheteraorticvalvereplacementtavraretrospectivecohortstudyofthenationalinpatientsample |