Prognostic impact of moderate or severe mitral regurgitation (MR) irrespective of concomitant comorbidities: a retrospective matched cohort study

Objective We sought to objectively quantify the independent impact of significant mitral regurgitation (MR) on prognosis in patients with multiple comorbidities and ascertain the extent to which median survival is affected by increasing comorbidities. Methods This was a retrospective matched cohort...

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Bibliographic Details
Published in:BMJ open 2014-07, Vol.4 (7), p.e004984-e004984
Main Authors: Prakash, Roshan, Horsfall, Matthew, Markwick, Andrew, Pumar, Marsus, Lee, Leong, Sinhal, Ajay, Joseph, Majo X, Chew, Derek P
Format: Article
Language:English
Subjects:
Age
Aged
Aged, 80 and over
Algorithms
Cardiovascular Medicine
Clinical outcomes
Clinical trials
Cohort Studies
Comorbidity
Estimates
Female
Heart attacks
Heart failure
Heart Failure - etiology
Humans
Lung diseases
Male
Mitral Valve Insufficiency - complications
Mitral Valve Insufficiency - diagnostic imaging
Mitral Valve Insufficiency - mortality
Mortality
Prognosis
Retrospective Studies
Severity of Illness Index
Studies
Ultrasonography
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Summary:Objective We sought to objectively quantify the independent impact of significant mitral regurgitation (MR) on prognosis in patients with multiple comorbidities and ascertain the extent to which median survival is affected by increasing comorbidities. Methods This was a retrospective matched cohort study using a clinical-echocardiography reporting database linked to a clinical and administrative database in an Australian tertiary hospital. We identified our study cohort (patients with significant MR) and control cohort (without MR) on transthoracic echocardiographies performed between 2005 and 2010. The main outcome measures were mortality and heart failure rehospitalisation. A Cox proportional hazards model was used to adjust for clinical covariates and the ‘win ratio’ methodology was utilised to estimate the impact of MR on main outcomes. Results A total of 218 matched patients with and without significant MR were followed-up for 1 year. Significant MR was associated with an adjusted HR for mortality of 1.83 (95% CI 1.28 to 2.62, p
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2014-004984